Feasible usage of ABO incompatible grafts in living donor liver transplantation
Identifieur interne : 000202 ( Main/Merge ); précédent : 000201; suivant : 000203Feasible usage of ABO incompatible grafts in living donor liver transplantation
Auteurs : Toru Ikegami ; Tomoharu Yoshizumi ; Yuji Soejima ; Hideaki Uchiyama ; Ken Shirabe ; Yoshihiko MaeharaSource :
- Hepatobiliary Surgery and Nutrition [ 2304-3881 ] ; 2016.
Abstract
The use of ABO incompatible (ABOi) graft in living donor liver transplantation (LDLT) has not been an established procedure worldwide.
Four hundred and eight adult LDLTs, using ABOi (n=19) and non-ABOi (n=389) grafts, were performed as a single center experience.
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%
ABOi-LDLT could be safely performed, especially under rituximab-based protocol.
Url:
DOI: 10.3978/j.issn.2304-3881.2015.06.02
PubMed: 27115002
PubMed Central: 4824747
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<author><name sortKey="Ikegami, Toru" sort="Ikegami, Toru" uniqKey="Ikegami T" first="Toru" last="Ikegami">Toru Ikegami</name>
</author>
<author><name sortKey="Yoshizumi, Tomoharu" sort="Yoshizumi, Tomoharu" uniqKey="Yoshizumi T" first="Tomoharu" last="Yoshizumi">Tomoharu Yoshizumi</name>
</author>
<author><name sortKey="Soejima, Yuji" sort="Soejima, Yuji" uniqKey="Soejima Y" first="Yuji" last="Soejima">Yuji Soejima</name>
</author>
<author><name sortKey="Uchiyama, Hideaki" sort="Uchiyama, Hideaki" uniqKey="Uchiyama H" first="Hideaki" last="Uchiyama">Hideaki Uchiyama</name>
</author>
<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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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Feasible usage of ABO incompatible grafts in living donor liver transplantation</title>
<author><name sortKey="Ikegami, Toru" sort="Ikegami, Toru" uniqKey="Ikegami T" first="Toru" last="Ikegami">Toru Ikegami</name>
</author>
<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>
<idno type="eISSN">2304-389X</idno>
<imprint><date when="2016">2016</date>
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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>
</TEI>
</record>
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