ABO-incompatible liver transplantation (ABOi LT) using conventional immunosuppression has been considered a contraindication due to the high risk for antibody-mediated complications potentially resulting in graft loss. However, organ shortage has led to the development of anti-A/B antibody reducing immunosuppressive protocols which have made the outcome after living donor (LD) ABOi LT equivalent to that achieved with LD ABO-compatible (ABOc). The experience of deceased donor (DD) ABOi LT is however still limited. In this article, we discuss the historical background and the results after ABOi LT, in the setting of both LD and DD transplantation. We also discuss the remaining hurdles and future strategies in the breaching of the ABO barrier for LT.
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http://dx.doi.org/10.1080/08830185.2019.1601720 | DOI Listing |
J Chin Med Assoc
January 2025
Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital, Taiwan, ROC.
Background: ABO-incompatible liver transplantation (ABOi LT) can now be successfully performed with standard pretransplant induction therapy. For patients with chronic end-stage liver disease (ESLD), ABOi LT can achieve long-term outcomes comparable to those of blood type-compatible (ABOc) LT. Outcomes of patients with acute liver failure (ALF) who undergo urgent transplantation surgery with a limited induction period should be further investigated.
View Article and Find Full Text PDFJ Clin Apher
December 2024
Department of Transfusion Medicine, Manipal Hospital, Jaipur, India.
ABO-incompatible transplantations are increasingly gaining relevance with advancements in therapeutic modalities, thus allowing patients to receive timely solid organ transplants. Therapeutic apheresis (TA) procedures remain instrumental as a preconditioning measure to enable such transplants. This survey was undertaken to find out current trends and practices of TA across major transplant centers in India.
View Article and Find Full Text PDFBest Pract Res Clin Gastroenterol
December 2024
Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm research unit 1193, Villejuif, F-94800, France. Electronic address:
ABO-compatible Orthotopic Liver Transplantation (OLT) is the standard treatment for patients with acute liver failure (ALF) who meet the criteria for poor prognosis. Contraindications to liver transplantation may be related to the presence of severe medical or psychiatric comorbidities, or to an unstable clinical state incompatible with transplantation. Early mortality predictive scores and factors have been developed to identify futile transplantations that exacerbate organ shortage.
View Article and Find Full Text PDFPediatr Transplant
February 2025
University of Cape Town, Cape Town, South Africa.
Background: Blood group incompatibility previously represented an obstacle to living related donor (LRD) options; desensitization modalities have expanded LRD options. ABO-incompatible kidney transplants have been successful in adults and pediatric liver transplants, but to date not yet in pediatric kidney transplants in South Africa.
Case Report: Patient X is a 5 year old male with end-stage kidney failure due to Posterior Urethral Valves, requiring peritoneal dialysis pre-transplant.
Transplant Proc
December 2024
Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
Background: Biliary stricture is a common complication after living-donor liver transplantation (LDLT), but its management is challenging. We herein report a case of successful internal drainage achieved through combination of the gun-sight technique and dual hepatic vascular embolization (DHVE).
Case Presentation: A 54-year-old woman with primary biliary cholangitis underwent ABO-incompatible LDLT with the right lobe.
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