American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2015
ABO-Incompatible Adult Living Donor Liver Transplantation Under the Desensitization Protocol With Rituximab.
Clinical StudyСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Song G-W, Lee S-G, Hwang S, Kim K-H, Ahn C-S, Moon D-B, Ha T-Y, Jung D-H, Park G-C, Kim W-J, Sin M-H, Yoon Y-I, Kang W-H, Kim S-H, Tak E-Y
Аннотация
ABO incompatibility is no longer considered a contraindication for adult living donor liver transplantation (ALDLT) due to various strategies to overcome the ABO blood group barrier. We report the largest single-center experience of ABO-incompatible (ABOi) ALDLT in 235 adult patients. The desensitization protocol included a single dose of rituximab and total plasma exchange. In addition, local graft infusion therapy, cyclophosphamide, or splenectomy was used for a certain time period, but these treatments were eventually discontinued due to adverse events. There were three cases (1.3%) of in-hospital mortality. The cumulative 3-year graft and patient survival rates were 89.2% and 92.3%, respectively, and were comparable to those of the ABO-compatible group (n = 1301). Despite promising survival outcomes, 17 patients (7.2%) experienced antibody-mediated rejection that manifested as diffuse intrahepatic biliary stricture; six cases required retransplantation, and three patients died. ABOi ALDLT is a feasible method for expanding a living liver donor pool, but the efficacy of the desensitization protocol in targeting B cell immunity should be optimized.