Abstract
196 Background: Controversy still surrounds the use of ABO non-identical grafts in liver transplantation, due to reported higher rates of graft failure and the scarce donor supply. This study was designed to determine the effect of transplantation across the ABO blood type on liver graft and patient survival for a large single transplant center. Methods: Retrospective review of liver transplant patient records obtained from the United Network for Organ Sharing (UNOS) Scientific Registry from October 1988 to February 17, 1997. Data was complete for 1341 patients, and the analysis was limited to first grafts. Average follow-up was 2.5 years. Patient and graft survival were determined for three combinations of ABO blood type matching between donor and recipient: ABO identical (ABO-Id) 1206 pts, ABO compatible (ABO-Comp) 101 pts, and ABO incompatible (ABO-Inc) 34 pts. Estimates of patient and graft survival were computed using the method of Kaplan-Meier. Results: Overall one year graft survival was 69% with overall patient survival of 78%. Thirty-two percent of patients were UNOS status one at time of transplant. UNOS status one and two patients were combined together for survival analysis. For UNOS status one and two patients, ABO-Id grafts have a higher graft survival as compared to ABO-Comp (p=.03) see Table 1. ABO-Id graft survival was also higher as compared to ABO-Inc, but it only approached statistical significance (p=.2), probably due to the low number of ABO-Inc patients. Survival for UNOS status three grafts was similar for the ABO-Id and ABO-Comp groups. Patient survival results were similar with ABO-Id survival being higher than for ABO-Comp and ABO-Inc groups, although not statistically significant (p>.11 for all comparisons). Conclusions: Both graft and patient survival for liver transplant recipients are comparable for ABO-Comp and ABO-Inc mismatching. These results support the use of grafts across the ABO blood barrier in urgent situations.Table 1: Survival summary
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