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ABO-Incompatible Liver Transplantation: State of Art and Future Perspectives

[ Vol. 26 , Issue. 28 ]

Author(s):

Chih-Hsien Cheng*, Chen-Fang Lee, Yu-Chao Wang, Tsung-Han Wu, Ting-Jung Wu, Hong-Shiue Chou, Kun-Ming Chan and Wei-Chen Lee   Pages 3406 - 3417 ( 12 )

Abstract:


ABO-incompatible (ABO-I) liver transplantation (LT) has been limited due to the increased rate of complications, including severe cellular and antibody-mediated rejection, hepatic necrosis, hepatic artery thrombosis, and biliary complications. However, several strategies for reducing preformed anti-donor ABO antibodies and B cell desensitization have improved the outcomes of ABO-I LT. As a result, ABO-I LT has become a routine procedure and is a feasible option in countries with a scarce deceased-organ donation or in cases without an available compatible organ donor. In this review, we describe past and present desensitizing protocols as well as emergent therapies for depleting B cell and anti-ABO antibodies with the objective of identifying approaches that could lead to new, refined strategies for maximizing the results of ABO-I LT.

Keywords:

ABO, incompatible, liver, transplantation, desensitization, isoagglutinin titer, rituximab, plasmapheresis.

Affiliation:

Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan



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