Objectives: Effect of ABO-incompatible liver transplantation on severe hepatitis B (SHB) patients is still unclear. Herein, we described 22 successful cases of patients with SHB who performed emergency liver transplantation from ABO-incompatible donors.

Methods:The immunosuppressive protocol consisted of basiliximab, tacrolimus, steroids and mycophenolate mofetil. Pretransplantation patients with hyperbilirubinemia in 4 ABO-incompatible cases underwent plasmapheresis.

Results: The mean age of recipients was 43.5 ± 9.1 years and the mean MELD score was 35.2 ± 7.1. There was no acute humoral rejection in recipients. Major complications included rejecion, infections, biliary, hepatic artery thrombosis, hepatic artery stenosis and portal vein thrombosis. Patient survivals, at a mean follow-up of 34.2 ± 20.3 months, were 40.9%, 78.9% and 82.3% in 1 year, 29.2%, 66.8% and 72.9% in 3 years, and 21.9%, 60.1% and 62.5% in 5 years for ABO-incompatible, ABO-compatible and ABO-identical graft recipients, respectively. Graft survivals were 39%, 78.9% and 82.3% in 1 year, 27.8%, 66.4% and 71.1% in 3 years, and 20.9%, 57.9% and 61% in 5 years for incompatible, compatible and identical grafts, respectively.

Conclusions: Our results suggest that ABO-incompatible liver transplantation as a life-saving procedure for SHB patients can be safely performed when ABO-compatible donors are not available and acceptable outcomes could be obtained.

« Back to 2015 American Transplant Congress