UNIGE document Scientific Article
previous document  unige:35295  next document
add to browser collection
Title

ABO-incompatible liver transplantation for critically ill adult patients

Authors
Al-Qahtani, Mohammed
Alsaif, Faisal A
Bigam, David L
Meeberg, Glenda A
James Shapiro, A M
Bain, Vincent G
Kneteman, Norman M
Published in Transplant International. 2007, vol. 20, no. 8, p. 675-81
Abstract ABO incompatible (ABO-In) liver transplant remains a controversial solution to acute liver failure in adults. Adult liver recipients with acute liver failure or severely decompensated end-stage disease, intubated and/or in the intensive care unit, were grouped as ABO-In (n = 14), ABO-compatible (n = 29, ABO-C) and ABO-identical (n = 65, ABO-Id). ABO-In received quadruple immunosuppression with antibody-depleting induction agents (except two), calcineurin inhibitors, antimetabolites and steroids. No significant difference of patient and graft survivals was observed among ABO-In, ABO-C and ABO-Id: graft survivals were 64%, 62% and 67%, respectively, in 1 year and 56%, 54% and 60%, respectively, in 5 years; patient survivals 86%, 69% and 67%, respectively, in 1 year and 77%, 61% and 62%, respectively, in 5 years. Three ABO-In grafts were lost (one hyper-acute rejection and two hepatic artery thrombosis). Surgical and infectious complications were similarly distributed between groups, except the hepatic artery thrombosis, more frequent in ABO-In (2, 14%) than ABO-I (1, 1.5%, P < 0.05). In contrast to previous studies, no significant difference of patient and graft survivals could be observed among all ABO-compatibility settings. Our results suggest that ABO-incompatible transplants should be viewed as an important therapeutic option in adult patients with acute liver failure awaiting an emergency procedure.
Keywords ABO Blood-Group System/immunologyAdolescentAdultAgedAlberta/epidemiologyCritical IllnessFemaleFollow-Up StudiesGraft Rejection/blood/epidemiology/prevention & controlGraft SurvivalHumansImmunosuppressive Agents/therapeutic useIncidenceLiver Failure/blood/surgeryLiver Transplantation/adverse effectsMaleMiddle AgedPrognosisRetrospective StudiesSurvival Rate
Identifiers
PMID: 17521384
Full text
Article (Published version) (498 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research group Transplantation et hépatologie (905)
Citation
(ISO format)
TOSO, Christian et al. ABO-incompatible liver transplantation for critically ill adult patients. In: Transplant International, 2007, vol. 20, n° 8, p. 675-81. doi: 10.1111/j.1432-2277.2007.00492.x https://archive-ouverte.unige.ch/unige:35295

371 hits

0 download

Update

Deposited on : 2014-04-02

Export document
Format :
Citation style :