Background and aims: ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) has a high success rate. However, a difference in hepatocellular carcinoma (HCC) recurrence rates has not been reported between ABO-compatible (ABO-C) and ABO-I LDLT. We compared HCC recurrence of ABO-I LDLT with that of ABO-C LDLT and identified the effect of ABO-incompatibility on HCC recurrence after LDLT.

Methods: At our institution, 240 patients underwent LDLT because of HCC between 2010 and 2015. Fifty-nine patients underwent ABO-I LDLT.

Results: Baseline, perioperative, and tumor characteristics were not different between the two groups. The incidence of HCC recurrence was 20.3% in the ABO-I LDLT group and 22.1% in the ABO-C LDLT group at the time of the last visit. The 1-, 2-, and 3-year disease-free survival rates in the ABO-I LDLT and ABO-C LDLT groups were 90.3%, 79.7%, 73.3% and 86.7%, 79.0%, 75.3%, respectively (p=0.964). The overall survival rates over the same period in the ABO-I LDLT and ABO-C LDLT groups were 90.6%, 85.0%, 81.9% and 88.0%, 83.5%, 82.5%, respectively (p=0.765). HCC recurrence was associated with alpha-fetoprotein (AFP) >35, increased tumor size, encapsulation, and microvascular invasion after LDLT.

Conclusion: The rate of HCC recurrence in the ABO-I LDLT group was comparable to that of the ABO-C LDLT, despite rituximab induced B-cell depletion. ABO-incompatibility was not related to HCC recurrence after LDLT.

CITATION INFORMATION: Kim J, Kim S, Lee J, Kim K.-S, Lee J, Choi G.-S, Park J, Kwon C, Joh J.-W, Lee S.-K. ABO-Incompatibility Using Ritiuximab Does Not Increase Hepatocellular Carcinoma Recurrence After Liver Transplantation. Am J Transplant. 2017;17 (suppl 3).

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