Outcome of ABO-Incompatible Living Donor Liver Retransplantation
Department of Transplantation and Pediatric Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Meeting: 2013 American Transplant Congress
Abstract number: B1081
[Introduction]
Liver retransplantation is required in patients with irreversible graft failure. Because the chance of deceased donor liver transplantation is still limited in Japan, many patients have to depend on living donor liver transplantation (LDLT). Selection of living donors among relatives in retransplantation is more difficult than in the primary one. Therefore, a part of patients cannot avoid ABO-incompatible donors. It has been known that both ABO-incompatible donors and the retransplantation are poor prognostic factors in liver transplantation. The aim of this study is to evaluate the outcome of ABO-incompatible living donor liver retransplantation (re-LDLT).
[Patients and Methods]
Five of 331 LDLT recipients between January 1998 and December 2011 in our institution underwent ABO-incompatible retransplantation after the initial living (n=4) or deceased donor (n=1) liver transplantation. Pre-, peri-, postoperative factors and outcome of ABO-incompatible re-LDLT were analyzed retrospectively.
[Results]
There were 2 males and 3 females and the age distribution was 3 to 41 years. One underwent ABO-incompatible primary transplantation. Causes of the re-LDLT were; ABO-incompatiblity in 1, chronic rejection in 2 and intractable rejection in 2. Donors of the initial/re-LDLT were; father/mother in 2, father/sister in 1, sister/mother in 1 and deceased donor/wife in 1. Mean follow up period after the re-LT was 27.2 months (ranging from 17 to 40). Mean MELD / PELD score was 18.8 (ranging from 4 to 30). Rituximab was administered to all of 5 patients 2 weeks before the operation. Pre-transplant plasma exchange was done in 2, and postoperative continuous infusion of PGE1 and steroid for two weeks from the portal vein catheter was performed in 2 of the 5 patients. The mean operative duration and postoperative hospital stay were 1045 minutes (ranging from 921 to 1389) and 78 days (ranging from 43 to118), respectively. There was no case of antibody mediated rejection, and as the surgical complications, one of 5 had bile leakage. All of 5 patients have been doing well.
[Conclusion]
Although ABO-incompatible re-LDLT is difficult, it can present a feasible option to patients with irreversible graft failure in in the era of the rituximab.
To cite this abstract in AMA style:
Ohya Y, Honda M, Hayashida S, Murokawa T, Suda H, Lee K, Yamamoto H, Takeichi T, Asonuma K, Inomata Y. Outcome of ABO-Incompatible Living Donor Liver Retransplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/outcome-of-abo-incompatible-living-donor-liver-retransplantation/. Accessed May 14, 2025.« Back to 2013 American Transplant Congress