| Autor: |
Hirukawa, Kazuya, Shinoda, Masahiro, Hasegawa, Yasushi, Obara, Hideaki, Kitago, Minoru, Yagi, Hiroshi, Abe, Yuta, Yamada, Yohei, Tanabe, Minoru, Kitagawa, Yuko |
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| Zdroj: |
Surgery Today; Oct2023, Vol. 53 Issue 10, p1160-1172, 13p |
| Abstrakt: |
Purpose: Acute liver failure is a life-threatening condition for which ABO-incompatible living donor liver transplantation (ABOi-LDLT) is sometimes the only life-saving treatment option. We reviewed a single-center experience of adult ABOi-LDLT treatment for acute liver failure (ALF). Methods: Preoperative treatment, immune indices (B cell marker, anti-donor blood-type antibody), and postoperative outcomes were compared between ALF and non-ALF groups. Results: There were 5 and 33 patients in the ALF and non-ALF groups, respectively. The ALF group received higher doses of steroids, underwent more rounds of plasma exchange (PE), and underwent transplantation for ALF with a shorter interval following preoperative rituximab (RTx) administration (median: 2 vs 13 days; P < 0.05) than the non-ALF group. Preoperatively, CD19-positive lymphocytes in the peripheral blood were sufficiently depleted in all of the non-ALF group patients, whereas they were poorly depleted in the ALF group. Postoperatively, neither group suffered anti-donor blood-type antibody titer rebound or antibody-mediated rejection. The ALF group had a comparable 5-year survival rate to the non-ALF group (80.0% vs 77.9%). Conclusions: Despite the delayed preoperative administration of RTx, the ALF group showed an uneventful immunological response and acceptable long-term survival rate. Thus, ABOi-LDLT seems a viable treatment option for ALF. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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