ABO-Incompatible Liver Transplantation (Report of 3Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GONG Wei , LIU Jun , YANG Fenghui , XU Shifeng , ZHOU Xu , YU Guangsheng , XU Yantian , LU Jun.

Department of Organ Transplantation and The Second Hepatobiliary Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, ChinaCorresponding Author: LIU Jun, E-mail: dr_liujun@hotmail.com;

Corresponding author：

Keywords：

Liver transplantation; Blood type incompatibility; Acute hepatic failure

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Objective 　To investigate the effect of ABO-incompatible liver transplantation on patients with acute hepatic failure.
　Methods 　A retrospective review was undertaken on the clinical data of 3 cases　（1 case of Budd-Chiari syndrome, 1 case of liver cancer and 1 case of severe hepatitis B were included） undergoing ABO-incompatible liver transplantation for acute hepatic failure. The patients were given quadruple immunosuppression after operation.
　Results 　Postoperative complications including pulmonary infection, central pontine myelionlysis and acute rejection was suffered from by the patient of Budd-Chiari syndrome who was then given a positive deal and had survived for more than 14 months. The patient of liver cancer was aggravated by severe infection who died of multiple organ failure on day 13 after operation. The patient with severe hepatitis B was made more severe by acute renal failure whose kidney function was restored with continuous renal replacement therapy.
　Conclusion 　The outcome of ABO-incompatible liver transplantation can be improved with refined peri-transplant management and better immunosuppressive strategies. ABO-incompatible liver transplantation should be viewed as an important option in patients with acute hepatic failure awaiting an emergency procedure.

Citation： GONG Wei,LIU Jun,YANG Fenghui,XU Shifeng,ZHOU Xu,YU Guangsheng,XU Yantian,LU Jun.. ABO-Incompatible Liver Transplantation (Report of 3Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(3): 187-190. doi: Copy

1.	Gordon RD, Fung JJ, Iwatsuki S, et al. Immunological factors influencing liver graft survival [Ｊ]. Gastroenterol Clin North Am, 1988; 17(1):53.
2.	Gugenheim J, Samuel D, Reynes M, et al. Liver transplantation across ABO blood group barriers [Ｊ]. Lancet, 1990; 336(8714):519.
3.	Reding R, Veyckemans F, de Ville de Goyet J, et al. ABO-incompatible orthotopic liver allografting in urgent indications [Ｊ]. Surg Gynecol Obstet, 1992; 174(1):59.
4.	Farges O, Kalil AN, Samuel D, et al. The use of ABO-incompatible grafts in liver transplantation: a life-saving procedure in highly selected patients [Ｊ]. Transplantation, 1995; 59(8):1124.
5.	Wu A, Bühler LH, Cooper DK. ABO-incompatible organ and bone marrow transplantation: current status　[Ｊ]. Transpl Int, 2003; 16(5):291.
6.	Rydberg L. ABO-incompatibility in solid organ transplantation [Ｊ]. Transfus Med, 2001; 11(4):325.
7.	Egawa H, Oike F, Buhler L, et al. Impact of recipient age on outcome of ABO-incompatible living-donor liver transplantation [Ｊ]. Transplantation, 2004; 77(3):403.
8.	Takahashi K, Saito K, Takahara S, et al. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan [Ｊ]. Am J Transplant, 2004; 4(7):1089.
9.	Sugawara Y, Makuuchi M. Adult liver transplantation using live ABO-incompatible grafts in Western countries [Ｊ]. Liver Transpl, 2006; 12(9):1324.
10.	Boberg KM, Foss A, Midtvedt K, et al. ABO-incompatible deceased donor liver transplantation with the use of antigen-specific immunoadsorption and anti-CD20 monoclonal antibody [Ｊ]. Clin Transplant, 2006; 20(2):265.
11.	Koukoutsis I, Bellagamba R, Tamijmarane A, et al. Outcomes after identical and compatible orthotopic liver transplantation for fulminant hepatic failure: a single center experience in UK [Ｊ]. Transpl Int, 2007; 20(8):659.
12.	Mahendran AO, Veitch PS. Paired exchange programmes can expand the live kidney donor pool [Ｊ]. Br J Surg, 2007; 94(6):657.
13.	Toso C, Al-Qahtani M, Alsaif FA, et al. ABO-incompatible liver transplantation for critically ill adult patients [Ｊ]. Transpl Int, 2007; 20(8):675.
14.	Skogsberg U, Breimer ME, Friman S, et al. Adult ABO-incompatible liver transplantation, using A and B donors [Ｊ]. Xenotransplantation, 2006;　13(2):154.
15.	Whiting JF, Fecteau A, Martin J, et al. Use of low-dose OKT3 as induction therapy in liver transplantation [Ｊ]. Transplantation, 1998; 65(4):577.
16.	Hashimoto T, Kondo S, Suzuki T, et al. Strategy for ABO-incompatible living-related liver transplantation [Ｊ]. Transplant Proc, 2000; 32(7):2104.
17.	Hanto DW, Fecteau AH, Alonso MH, et al. ABO-incompatible liver transplantation with no immunological graft losses using total plasma exchange, splenectomy, and quadruple immunosuppression: evidence for accommodation [Ｊ]. Liver Transpl, 2003; 9(1):22.
18.	Kawagishi N, Satoh K, Enomoto Y, et al. New strategy for ABO-incompatible living donor liver transplantation with anti-CD20 antibody (rituximab) and plasma exchange [Ｊ]. Transplant Proc, 2005; 37(2):1205.
19.	李军, 窦科峰, 朱靓, 等. 人肝移植术后移植肝脏热休克蛋白70的表达及意义 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(6):426.
20.	朱新锋, 陈刚, 张文夺, 等. 肝移植术后应用胸腺肽α1对急性排斥反应的影响 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(6):430.
21.	Kozaki K, Egawa H, Kasahara M, et al. Therapeutic strategy and the role of apheresis therapy for ABO incompatible living donor liver transplantation [Ｊ]. Ther Apher Dial, 2005; 9(4):285.
22.	Kozaki K, Egawa H, Ueda M, et al. The role of apheresis therapy for ABO incompatible living donor liver transplantation: the Kyoto University experience [Ｊ]. Ther Apher Dial, 2006; 10(5):441.
23.	叶启发, 佘兴国, 明英姿, 等. 脾切除对肝移植预后影响的回顾性探讨 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(3):159.

1. Gordon RD, Fung JJ, Iwatsuki S, et al. Immunological factors influencing liver graft survival [Ｊ]. Gastroenterol Clin North Am, 1988; 17(1):53.
2. Gugenheim J, Samuel D, Reynes M, et al. Liver transplantation across ABO blood group barriers [Ｊ]. Lancet, 1990; 336(8714):519.
3. Reding R, Veyckemans F, de Ville de Goyet J, et al. ABO-incompatible orthotopic liver allografting in urgent indications [Ｊ]. Surg Gynecol Obstet, 1992; 174(1):59.
4. Farges O, Kalil AN, Samuel D, et al. The use of ABO-incompatible grafts in liver transplantation: a life-saving procedure in highly selected patients [Ｊ]. Transplantation, 1995; 59(8):1124.
5. Wu A, Bühler LH, Cooper DK. ABO-incompatible organ and bone marrow transplantation: current status　[Ｊ]. Transpl Int, 2003; 16(5):291.
6. Rydberg L. ABO-incompatibility in solid organ transplantation [Ｊ]. Transfus Med, 2001; 11(4):325.
7. Egawa H, Oike F, Buhler L, et al. Impact of recipient age on outcome of ABO-incompatible living-donor liver transplantation [Ｊ]. Transplantation, 2004; 77(3):403.
8. Takahashi K, Saito K, Takahara S, et al. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan [Ｊ]. Am J Transplant, 2004; 4(7):1089.
9. Sugawara Y, Makuuchi M. Adult liver transplantation using live ABO-incompatible grafts in Western countries [Ｊ]. Liver Transpl, 2006; 12(9):1324.
10. Boberg KM, Foss A, Midtvedt K, et al. ABO-incompatible deceased donor liver transplantation with the use of antigen-specific immunoadsorption and anti-CD20 monoclonal antibody [Ｊ]. Clin Transplant, 2006; 20(2):265.
11. Koukoutsis I, Bellagamba R, Tamijmarane A, et al. Outcomes after identical and compatible orthotopic liver transplantation for fulminant hepatic failure: a single center experience in UK [Ｊ]. Transpl Int, 2007; 20(8):659.
12. Mahendran AO, Veitch PS. Paired exchange programmes can expand the live kidney donor pool [Ｊ]. Br J Surg, 2007; 94(6):657.
13. Toso C, Al-Qahtani M, Alsaif FA, et al. ABO-incompatible liver transplantation for critically ill adult patients [Ｊ]. Transpl Int, 2007; 20(8):675.
14. Skogsberg U, Breimer ME, Friman S, et al. Adult ABO-incompatible liver transplantation, using A and B donors [Ｊ]. Xenotransplantation, 2006;　13(2):154.
15. Whiting JF, Fecteau A, Martin J, et al. Use of low-dose OKT3 as induction therapy in liver transplantation [Ｊ]. Transplantation, 1998; 65(4):577.
16. Hashimoto T, Kondo S, Suzuki T, et al. Strategy for ABO-incompatible living-related liver transplantation [Ｊ]. Transplant Proc, 2000; 32(7):2104.
17. Hanto DW, Fecteau AH, Alonso MH, et al. ABO-incompatible liver transplantation with no immunological graft losses using total plasma exchange, splenectomy, and quadruple immunosuppression: evidence for accommodation [Ｊ]. Liver Transpl, 2003; 9(1):22.
18. Kawagishi N, Satoh K, Enomoto Y, et al. New strategy for ABO-incompatible living donor liver transplantation with anti-CD20 antibody (rituximab) and plasma exchange [Ｊ]. Transplant Proc, 2005; 37(2):1205.
19. 李军, 窦科峰, 朱靓, 等. 人肝移植术后移植肝脏热休克蛋白70的表达及意义 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(6):426.
20. 朱新锋, 陈刚, 张文夺, 等. 肝移植术后应用胸腺肽α1对急性排斥反应的影响 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(6):430.
21. Kozaki K, Egawa H, Kasahara M, et al. Therapeutic strategy and the role of apheresis therapy for ABO incompatible living donor liver transplantation [Ｊ]. Ther Apher Dial, 2005; 9(4):285.
22. Kozaki K, Egawa H, Ueda M, et al. The role of apheresis therapy for ABO incompatible living donor liver transplantation: the Kyoto University experience [Ｊ]. Ther Apher Dial, 2006; 10(5):441.
23. 叶启发, 佘兴国, 明英姿, 等. 脾切除对肝移植预后影响的回顾性探讨 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(3):159.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

ABO-Incompatible Liver Transplantation (Report of 3Cases)

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