title: Case-matched comparison of ABO-incompatible and ABO-compatible living donor liver transplantation.
abstract: BACKGROUND
  ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) has a high success rate. There are few detailed comparisons regarding biliary complications, infective complications and patient survival between ABO-compatible (ABO-C) and ABO-I LDLT. The aim was to compare the outcomes of ABO-I LDLT with those of ABO-C LDLT using the matched-pairs method.
  
  
  METHODS
  Patients who underwent ABO-I LDLT procedures between 2010 and 2013 were studied. They were matched for significant variables with patients who had ABO-C LDLT (1:2 matching).
  
  
  RESULTS
  Forty-seven ABO-I LDLT procedures were included. Ninety-four patients who had ABO-C LDLT were selected as a comparator group. The incidence of cytomegalovirus, bacterial and fungal infections during the first 3 months was similar after ABO-I LDLT and ABO-C LDLT (85 versus 76 per cent, 28 versus 37 per cent, and 13 versus 20 per cent, respectively). Antibody-mediated rejection occurred after two procedures within 2 weeks of transplantation, but liver function improved with plasma exchange in both patients. There were no differences in the rate of acute rejection and biliary complications between ABO-I and ABO-C groups (P = 0.478 and P = 0.511 respectively). Three patients who had ABO-I LDLT developed diffuse intrahepatic biliary complications and progressed to graft failure. The 1-, 2- and 3-year patient survival rates after ABO-I LDLT and ABO-C LDLT were 89 versus 87 per cent, 85 versus 83 per cent, and 85 versus 79 per cent, respectively.
  
  
  CONCLUSIONS
  The short-term outcomes of ABO-I LDLT were comparable to those of ABO-C LDLT in this study. ABO-I LDLT is an effective and safe transplant option with the potential to expand the pool of live donors.
authors.affiliation: Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J M
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: C H D
authors.initials: CH
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J-W
authors.initials: JW
authors.lastname: Joh
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: S B
authors.initials: SB
authors.lastname: Han
authors.affiliation: Division of Gastroenterology, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Sinn
authors.affiliation: Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: G-S
authors.initials: GS
authors.lastname: Choi
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: E-S
authors.initials: ES
authors.lastname: Kang
authors.affiliation: Division of Gastroenterology, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: G S
authors.initials: GS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: S-K
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System