HapticV1, Main, Exploration, bibRecord, 000202

Feasible usage of ABO incompatible grafts in living donor liver transplantation

Identifieur interne : 000202 ( Main/Exploration ); précédent : 000201; suivant : 000203

Feasible usage of ABO incompatible grafts in living donor liver transplantation

Auteurs : Toru Ikegami ; Tomoharu Yoshizumi ; Yuji Soejima ; Hideaki Uchiyama ; Ken Shirabe ; Yoshihiko Maehara

Source :

Hepatobiliary Surgery and Nutrition [ 2304-3881 ] ; 2016.

RBID : PMC:4824747

Abstract

Background

The use of ABO incompatible (ABOi) graft in living donor liver transplantation (LDLT) has not been an established procedure worldwide.

Methods

Four hundred and eight adult LDLTs, using ABOi (n=19) and non-ABOi (n=389) grafts, were performed as a single center experience.

Results

In ABOi-LDLT group (n=19), median isoagglutinin titer before plasma exchange (PE) at LDLT and after LDLT (max) was ×256, ×32 and ×32, respectively. Rituximab was given at 21.8±6.1 days before LDLT and PE was performed 3.7±1.6 times. Although ABOi-LDLTs had increased rate of splenectomy (89.4% vs. 44.7%, P<0.001) and lower portal venous pressure (PVP) at the end of surgery (13.8±1.1 vs. 16.9±0.2 mmHg, P=0.003), other operative factors including graft ischemic time, operative time and blood loss were not different between the groups. Although ABOi-LDLTs had increased incidence of cytomegalovirus infection (52.6% vs. 22.9%, P=0.007), other post-transplant complications including bacterial sepsis and acute rejection were not different between the groups. The 5-year graft survival rate was 87.9% in ABOi-LDLTs and 80.3% in non-ABOi-LDLTs (P=0.373).

Conclusions

ABOi-LDLT could be safely performed, especially under rituximab-based protocol.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824747

DOI: 10.3978/j.issn.2304-3881.2015.06.02
PubMed: 27115002
PubMed Central: 4824747

Affiliations:

Le document en format XML

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<author><name sortKey="Ikegami, Toru" sort="Ikegami, Toru" uniqKey="Ikegami T" first="Toru" last="Ikegami">Toru Ikegami</name>
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<author><name sortKey="Yoshizumi, Tomoharu" sort="Yoshizumi, Tomoharu" uniqKey="Yoshizumi T" first="Tomoharu" last="Yoshizumi">Tomoharu Yoshizumi</name>
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<author><name sortKey="Soejima, Yuji" sort="Soejima, Yuji" uniqKey="Soejima Y" first="Yuji" last="Soejima">Yuji Soejima</name>
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<author><name sortKey="Uchiyama, Hideaki" sort="Uchiyama, Hideaki" uniqKey="Uchiyama H" first="Hideaki" last="Uchiyama">Hideaki Uchiyama</name>
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<author><name sortKey="Shirabe, Ken" sort="Shirabe, Ken" uniqKey="Shirabe K" first="Ken" last="Shirabe">Ken Shirabe</name>
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<author><name sortKey="Maehara, Yoshihiko" sort="Maehara, Yoshihiko" uniqKey="Maehara Y" first="Yoshihiko" last="Maehara">Yoshihiko Maehara</name>
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<author><name sortKey="Yoshizumi, Tomoharu" sort="Yoshizumi, Tomoharu" uniqKey="Yoshizumi T" first="Tomoharu" last="Yoshizumi">Tomoharu Yoshizumi</name>
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<author><name sortKey="Soejima, Yuji" sort="Soejima, Yuji" uniqKey="Soejima Y" first="Yuji" last="Soejima">Yuji Soejima</name>
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<author><name sortKey="Uchiyama, Hideaki" sort="Uchiyama, Hideaki" uniqKey="Uchiyama H" first="Hideaki" last="Uchiyama">Hideaki Uchiyama</name>
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<author><name sortKey="Shirabe, Ken" sort="Shirabe, Ken" uniqKey="Shirabe K" first="Ken" last="Shirabe">Ken Shirabe</name>
</author>
<author><name sortKey="Maehara, Yoshihiko" sort="Maehara, Yoshihiko" uniqKey="Maehara Y" first="Yoshihiko" last="Maehara">Yoshihiko Maehara</name>
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<series><title level="j">Hepatobiliary Surgery and Nutrition</title>
<idno type="ISSN">2304-3881</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The use of ABO incompatible (ABOi) graft in living donor liver transplantation (LDLT) has not been an established procedure worldwide.</p>
</sec>
<sec><title>Methods</title>
<p>Four hundred and eight adult LDLTs, using ABOi (n=19) and non-ABOi (n=389) grafts, were performed as a single center experience.</p>
</sec>
<sec><title>Results</title>
<p>In ABOi-LDLT group (n=19), median isoagglutinin titer before plasma exchange (PE) at LDLT and after LDLT (max) was ×256, ×32 and ×32, respectively. Rituximab was given at 21.8±6.1 days before LDLT and PE was performed 3.7±1.6 times. Although ABOi-LDLTs had increased rate of splenectomy (89.4% <italic>vs.</italic>
 44.7%, P<0.001) and lower portal venous pressure (PVP) at the end of surgery (13.8±1.1 <italic>vs.</italic>
 16.9±0.2 mmHg, P=0.003), other operative factors including graft ischemic time, operative time and blood loss were not different between the groups. Although ABOi-LDLTs had increased incidence of cytomegalovirus infection (52.6% <italic>vs.</italic>
 22.9%, P=0.007), other post-transplant complications including bacterial sepsis and acute rejection were not different between the groups. The 5-year graft survival rate was 87.9% in ABOi-LDLTs and 80.3% in non-ABOi-LDLTs (P=0.373).</p>
</sec>
<sec><title>Conclusions</title>
<p>ABOi-LDLT could be safely performed, especially under rituximab-based protocol.</p>
</sec>
</div>
</front>
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<affiliations><list></list>
<tree><noCountry><name sortKey="Ikegami, Toru" sort="Ikegami, Toru" uniqKey="Ikegami T" first="Toru" last="Ikegami">Toru Ikegami</name>
<name sortKey="Maehara, Yoshihiko" sort="Maehara, Yoshihiko" uniqKey="Maehara Y" first="Yoshihiko" last="Maehara">Yoshihiko Maehara</name>
<name sortKey="Shirabe, Ken" sort="Shirabe, Ken" uniqKey="Shirabe K" first="Ken" last="Shirabe">Ken Shirabe</name>
<name sortKey="Soejima, Yuji" sort="Soejima, Yuji" uniqKey="Soejima Y" first="Yuji" last="Soejima">Yuji Soejima</name>
<name sortKey="Uchiyama, Hideaki" sort="Uchiyama, Hideaki" uniqKey="Uchiyama H" first="Hideaki" last="Uchiyama">Hideaki Uchiyama</name>
<name sortKey="Yoshizumi, Tomoharu" sort="Yoshizumi, Tomoharu" uniqKey="Yoshizumi T" first="Tomoharu" last="Yoshizumi">Tomoharu Yoshizumi</name>
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Serveur d'exploration sur les dispositifs haptiques

Feasible usage of ABO incompatible grafts in living donor liver transplantation

Feasible usage of ABO incompatible grafts in living donor liver transplantation

Source :

Abstract

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