ABO-incompatible adult living donor liver transplantation under the desensitization protocol with rituximab
- Authors
- Song G.-W.; Lee S.-G.; Hwang S.; Kim K.-H.; Ahn C.-S.; Moon D.-B.; Ha T.-Y.; Jung D.-H.; Park G.-C.; Kim W.-J.; Sin M.-H.; Yoon Y.-I.; Kang W.-H.; Kim S.-H.; Tak E.-Y.
- Issue Date
- Sep-2016
- Publisher
- Blackwell Publishing Ltd
- Citation
- American Journal of Transplantation, v.16, no.1, pp 157 - 170
- Pages
- 14
- Indexed
- SCIE
SCOPUS
- Journal Title
- American Journal of Transplantation
- Volume
- 16
- Number
- 1
- Start Page
- 157
- End Page
- 170
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/43457
- DOI
- 10.1111/ajt.13444
- ISSN
- 1600-6135
1600-6143
- Abstract
- ABO incompatibility is no longer considered a contraindication for adult living donor liver transplantation (ALDLT) due to various strategies to overcome the ABO blood group barrier. We report the largest single-center experience of ABO-incompatible (ABOi) ALDLT in 235 adult patients. The desensitization protocol included a single dose of rituximab and total plasma exchange. In addition, local graft infusion therapy, cyclophosphamide, or splenectomy was used for a certain time period, but these treatments were eventually discontinued due to adverse events. There were three cases (1.3%) of in-hospital mortality. The cumulative 3-year graft and patient survival rates were 89.2% and 92.3%, respectively, and were comparable to those of the ABO-compatible group (n = 1301). Despite promising survival outcomes, 17 patients (7.2%) experienced antibody-mediated rejection that manifested as diffuse intrahepatic biliary stricture; six cases required retransplantation, and three patients died. ABOi ALDLT is a feasible method for expanding a living liver donor pool, but the efficacy of the desensitization protocol in targeting B cell immunity should be optimized. This article presents the clinical results of ABO-incompatible adult living donor liver transplantation in a single institution. Copyright © 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
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Collections - 2. Clinical Science > Department of Hepato-Biliary-Pancreatic Surgery > 1. Journal Articles
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