Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience.
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Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience. / Goralczyk, Armin D; Obed, Aiman; Schnitzbauer, Andreas; Doenecke, Axel; Tsui, Tung Yu; Scherer, Marcus N; Ramadori, Giuliano; Lorf, Thomas.
In: J Transplant, Vol. 2009, 2009, p. 759581.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience.
AU - Goralczyk, Armin D
AU - Obed, Aiman
AU - Schnitzbauer, Andreas
AU - Doenecke, Axel
AU - Tsui, Tung Yu
AU - Scherer, Marcus N
AU - Ramadori, Giuliano
AU - Lorf, Thomas
PY - 2009
Y1 - 2009
N2 - Adult living donor liver transplantations (ALDLTs) across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins) were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR). Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety.
AB - Adult living donor liver transplantations (ALDLTs) across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins) were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR). Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety.
M3 - SCORING: Zeitschriftenaufsatz
VL - 2009
SP - 759581
JO - J Transplant
JF - J Transplant
SN - 2090-0007
ER -
