J Korean Soc Transplant.
1997 May;11(1):145-150.
Living Related Liver Transplantation Across ABO Blood Groups
- Affiliations
-
- 1Department of Pediatrics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- 2Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- 3Department of Clinical Pathology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- 4Department of Plastic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- 5Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- 6Department of Anesthesiology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- 7Department of Transplant Coordinator, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
Abstract
- To overcome the shortage of available organ in children, living-related liver transplantation(LRLT) has been introduced in Asan Medical Center since 1994. However, the use of graft livers across ABO blood groups is unavoidable since the organ donor is usually one of the recipient's parents in LRLT cases. In ABO-incompatible liver transplants from brain dead donors, the incidences of perioperative mortality, arterial thrombosis, and irreversible rejection and the rate of retransplantation have been reported to be greater. But recent reports from LRLT showed that 1-year survival rate of ABO incompatible cases were approximately 80%. So we started ABO incompatible LRLTs at our institute since Feb, 1996. Three cases of ABO incompatible LRLT have been performed thereafter, 2 with fulminant hepatitis and 1 with cirrhosis. Plasma pheresis or exchange transfusion was done to decrease isohemagglutinin perioperatively. Immunosuppression consisted of a quadruple-drug treatment in one, FK506 and steroid in two. The follow-up periods were 2, 4 and 13 months respectively. One child died of acute respiratory distress syndrome with normal graft function on 51st postoperative day. Two children are alive with good health, but one of them suffers S2 segment bile duct stricture, which is under the management with PTBD. The present results suggest that ABO incompatilbe LRLTs can be performed to overcome the shortage of the liver in children using a combination of the preioperative plasma pheresis and immunosuppression.
MeSH Terms
-
Bile Ducts
Blood Component Removal
Blood Group Antigens*
Brain Death
Child
Chungcheongnam-do
Constriction, Pathologic
Fibrosis
Follow-Up Studies
Hepatitis
Humans
Immunosuppression
Incidence
Liver Transplantation*
Liver*
Mortality
Parents
Plasma
Respiratory Distress Syndrome, Adult
Survival Rate
Tacrolimus
Thrombosis
Tissue Donors
Transplants
Blood Group Antigens
Tacrolimus
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