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ABO-Incompatible Liver Transplantation in Acute Liver Failure: A Single Portuguese Center Study

2013Journal article Open access
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dc.contributor.authorMendes, M
dc.contributor.authorFerreira, AC
dc.contributor.authorFerreira, A
dc.contributor.authorRemédio, F
dc.contributor.authorAires, I
dc.contributor.authorCordeiro, A
dc.contributor.authorMascarenhas, A
dc.contributor.authorMartins, A
dc.contributor.authorPereira, P
dc.contributor.authorGlória, H
dc.contributor.authorPerdigoto, R
dc.contributor.authorVeloso, J
dc.contributor.authorFerreira, P
dc.contributor.authorOliveira, J
dc.contributor.authorSilva, M
dc.contributor.authorBarroso, E
dc.contributor.authorNolasco, F
dc.date.accessioned2013-05-08T15:07:10Z
dc.date.available2013-05-08T15:07:10Z
dc.date.issued2013
dc.description.abstractINTRODUCTION: ABO-incompatible liver transplantation (ABOi LT) is considered to be a rescue option in emergency transplantation. Herein, we have reported our experience with ABOi LT including long-term survival and major complications in these situations. PATIENT AND METHODS: ABOi LT was performed in cases of severe hepatic failure with imminent death. The standard immunosuppression consisted of basiliximab, corticosteroids, tacrolimus, and mycophenolate mofetil. Pretransplantation patients with anti-ABO titers above 16 underwent plasmapheresis. If the titer was above 128, intravenous immunoglobulin (IVIG) was added at the end of plasmapheresis. The therapeutic approach was based on the clinical situation, hepatic function, and titer evolution. A rapid increase in titer required five consecutive plasmapheresis sessions followed by administration of IVIG, and at the end of the fifth session, rituximab. RESULTS: From January 2009 to July 2012, 10 patients, including 4 men and 6 women of mean age 47.8 years (range, 29 to 64 years), underwent ABOi LT. At a mean follow-up of 19.6 months (range, 2 days to 39 months), 5 patients are alive including 4 with their original grafts. One patient was retransplanted at 9 months. Major complications were infections, which were responsible for 3 deaths due to multiorgan septic failure (2 during the first month); rejection episodes (4 biopsy-proven of humoral rejections in 3 patients and 1 cellular rejection) and biliary. CONCLUSION: The use of ABOi LT as a life-saving procedure is justifiable in emergencies when no other donor is available. With careful recipient selection close monitoring of hemagglutinins and specific immunosuppression we have obtained acceptable outcomes.por
dc.identifier.citationTransplant Proc. 2013 Apr;45(3):1110-5por
dc.identifier.urihttp://hdl.handle.net/10400.17/1241
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherElsevierpor
dc.subjectTransplantação de Fígadopor
dc.subjectFalência Hepática Agudapor
dc.subjectHCC NEF
dc.subjectSistema do Grupo Sanguíneo ABO
dc.subjectAnticorpos Monoclonais Murinos
dc.subjectTerapêutica e Dosagem
dc.subjectImunoglobulinas Intravenosas
dc.subjectImunossupressores
dc.subjectPlasmaferese
dc.subjectPortugal
dc.subjectHCC CIR
dc.subjectHCC GAS
dc.subjectHCC UCI
dc.subjectHCC HEM
dc.titleABO-Incompatible Liver Transplantation in Acute Liver Failure: A Single Portuguese Center Studypor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1115por
oaire.citation.startPage1110por
oaire.citation.titleTransplantation Proceedingspor
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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