Living donor liver transplantation using sensitized lymphocytotoxic crossmatch positive graft
| Autor: | Taku Aoki, Norihiro Kokudo, Michiro Takahashi, Kiyoshi Hasegawa, Sumihito Tamura, Kouki Takahashi, Junichi Kaneko, Noriyo Yamashiki, Yoshikuni Kawaguchi, Yasuhiko Sugawara |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Graft Rejection medicine.medical_specialty Cirrhosis Basiliximab medicine.medical_treatment Recombinant Fusion Proteins Case Report Liver transplantation Lymphocytotoxic crossmatch Postoperative Complications Internal medicine Living Donors Medicine & Public Health Internal Medicine Medicine Humans Anti-CD25 antibody Antilymphocyte Serum Hepatology business.industry Living donor Histocompatibility Testing Gastroenterology Antibodies Monoclonal Perioperative Plasmapheresis medicine.disease Surgery Liver Transplantation Surgical Oncology Oncology Desensitization Immunologic Rituximab Female business Colorectal Surgery Immunosuppressive Agents medicine.drug Abdominal surgery T-Lymphocytes Cytotoxic |
| Zdroj: | Journal of Gastroenterology |
| ISSN: | 1435-5922 |
| Popis: | We describe a successful living donor liver transplantation (LDLT) using a lymphocytotoxic crossmatch highly positive graft. A 41-year-old woman with alcoholic liver cirrhosis was referred as a potential candidate for LDLT, and her husband was willing to donate his partial liver. As the T-lymphocytotoxic crossmatch titer was over 10,000×, the patient was first infused with rituximab for preoperative desensitization, and then five rounds of plasmapheresis were performed. After the third plasmapheresis, the lymphocytotoxic crossmatch test was negative. A left liver graft including the caudate lobe was implanted, and anti-CD25 antibody (basiliximab) was administered on postoperative days 1 and 4. The postoperative course was uneventful except for an episode of mild acute cellular rejection on postoperative day 27. Although the impact of a lymphocytotoxic crossmatch-positive liver graft on acute cellular rejection and graft survival in LDLT remains controversial, perioperative desensitization may provide benefits when using a highly sensitized liver graft. |
| Databáze: | OpenAIRE |
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