Successful experiences of ABO-incompatible adult living donor liver transplantation for high-urgency patients in a single institute

Abstract

ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) is not a suitable treatment option for high-urgency patients because of a preparatory period (about two weeks). This report presents our experience in ABOi ALDLT in 3 patients with high-urgent circumstances between December 2014 and August 2015. The mean age of recipients was 48.5 ± 5.7 years (range, 40–54 years). The mean Model for End-stage Liver-Disease score was 20 ± 4.0 (range, 9–22). The plasma exchange (PE) was performed 3 days after administration of rituximab. Two times of PE were done in all case before ALDLT. Isoagglutinin (IA) titers and CD19+/CD20% ratios of all patients were below 1:8 and 1.0%. The one patient experienced postoperative complication that need to surgical approach (wound dehiscence). The all of the patients and graft survivals were 100% at a mean follow-up period of 6months. There was no episode of antibody-mediated rejection (AMR). ABOi ALDLT for high-urgency patients, therefore seems to be a safe and feasible therapeutic modality.