Long-term outcomes following ABO-incompatible living donor liver transplantation for acute liver failure : a single-center experience of over 20 years
© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd..
PURPOSE: Acute liver failure is a life-threatening condition for which ABO-incompatible living donor liver transplantation (ABOi-LDLT) is sometimes the only life-saving treatment option. We reviewed a single-center experience of adult ABOi-LDLT treatment for acute liver failure (ALF).
METHODS: Preoperative treatment, immune indices (B cell marker, anti-donor blood-type antibody), and postoperative outcomes were compared between ALF and non-ALF groups.
RESULTS: There were 5 and 33 patients in the ALF and non-ALF groups, respectively. The ALF group received higher doses of steroids, underwent more rounds of plasma exchange (PE), and underwent transplantation for ALF with a shorter interval following preoperative rituximab (RTx) administration (median: 2 vs 13 days; P < 0.05) than the non-ALF group. Preoperatively, CD19-positive lymphocytes in the peripheral blood were sufficiently depleted in all of the non-ALF group patients, whereas they were poorly depleted in the ALF group. Postoperatively, neither group suffered anti-donor blood-type antibody titer rebound or antibody-mediated rejection. The ALF group had a comparable 5-year survival rate to the non-ALF group (80.0% vs 77.9%).
CONCLUSIONS: Despite the delayed preoperative administration of RTx, the ALF group showed an uneventful immunological response and acceptable long-term survival rate. Thus, ABOi-LDLT seems a viable treatment option for ALF.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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| Enthalten in: |
Surgery today - 53(2023), 10 vom: 19. Okt., Seite 1160-1172 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hirukawa, Kazuya [VerfasserIn] |
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| Links: |
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| Themen: |
4F4X42SYQ6 |
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| Anmerkungen: |
Date Completed 02.10.2023 Date Revised 02.10.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00595-023-02678-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357749863 |
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| 245 | 1 | 0 | |a Long-term outcomes following ABO-incompatible living donor liver transplantation for acute liver failure |b a single-center experience of over 20 years |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. | ||
| 520 | |a PURPOSE: Acute liver failure is a life-threatening condition for which ABO-incompatible living donor liver transplantation (ABOi-LDLT) is sometimes the only life-saving treatment option. We reviewed a single-center experience of adult ABOi-LDLT treatment for acute liver failure (ALF) | ||
| 520 | |a METHODS: Preoperative treatment, immune indices (B cell marker, anti-donor blood-type antibody), and postoperative outcomes were compared between ALF and non-ALF groups | ||
| 520 | |a RESULTS: There were 5 and 33 patients in the ALF and non-ALF groups, respectively. The ALF group received higher doses of steroids, underwent more rounds of plasma exchange (PE), and underwent transplantation for ALF with a shorter interval following preoperative rituximab (RTx) administration (median: 2 vs 13 days; P < 0.05) than the non-ALF group. Preoperatively, CD19-positive lymphocytes in the peripheral blood were sufficiently depleted in all of the non-ALF group patients, whereas they were poorly depleted in the ALF group. Postoperatively, neither group suffered anti-donor blood-type antibody titer rebound or antibody-mediated rejection. The ALF group had a comparable 5-year survival rate to the non-ALF group (80.0% vs 77.9%) | ||
| 520 | |a CONCLUSIONS: Despite the delayed preoperative administration of RTx, the ALF group showed an uneventful immunological response and acceptable long-term survival rate. Thus, ABOi-LDLT seems a viable treatment option for ALF | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ABO incompatible | |
| 650 | 4 | |a Acute liver failure | |
| 650 | 4 | |a Living donor liver transplantation | |
| 650 | 4 | |a Rituximab | |
| 650 | 4 | |a Steroids | |
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| 700 | 1 | |a Shinoda, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Hasegawa, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Obara, Hideaki |e verfasserin |4 aut | |
| 700 | 1 | |a Kitago, Minoru |e verfasserin |4 aut | |
| 700 | 1 | |a Yagi, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Abe, Yuta |e verfasserin |4 aut | |
| 700 | 1 | |a Yamada, Yohei |e verfasserin |4 aut | |
| 700 | 1 | |a Tanabe, Minoru |e verfasserin |4 aut | |
| 700 | 1 | |a Kitagawa, Yuko |e verfasserin |4 aut | |
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