Korean J Transplant.  2023 Dec;37(4):306-309. 10.4285/kjt.23.0070.

Accidental ABO-incompatible pediatric liver transplantation with blood group antigen immune and operational tolerance: a case report with 21 years of follow-up

• Kim HS
• Choi SJN
• Lee HK
• Lee S

• KMID: 2550243
• DOI: http://doi.org/10.4285/kjt.23.0070

Abstract

Liver transplantation is a critical procedure for patients with end-stage liver disease, but it is often hindered by ABO-incompatibility between the donor and recipient, which can lead to immediate humoral rejection. We present a unique case involving a 10-monthold patient who, by accident, received an ABO-incompatible partial liver transplant from a type A mother without undergoing desensitization. Remarkably, during a 21-year follow-up period, the patient exhibited no signs of humoral or graft rejection, despite nonadherence to medication. This case highlights the possibility of dual tolerance in pediatric ABO-incompatible liver transplantation and provides insights into immune tol-erance mechanisms, with implications for enhancing patient care and reducing healthcare costs. Further research is necessary to clarify these mechanisms and to evaluate the long-term durability of tolerance in pediatric transplant recipients.

Keyword

Immune tolerance; ABO blood-group system; Liver transplantation; Case report

Figure

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  Fig. 1 Computed tomography images at 21 years after transplantation. (A) Coronal view: patent hepatic artery and portal vein flow with splenomegaly and perisplenic varices. (B) Axial view: patent portal flow and hepatic vein flow without bile duct dilatation.

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