LIVING RELATED LIVER TRANSPLANTATION ACROSS ABO BLOOD GROUPS

Authors:
  • KTKoichi Tanaka
    Koichi Tanaka
  • TKToshiyuki Kitai
    Toshiyuki Kitai
  • NYNobuharu Yanabu
    Nobuharu Yanabu
  • ATAtsuo Tokuka
    Atsuo Tokuka
  • BSBunpei Sato
    Bunpei Sato
  • SMShigeto Mori
    Shigeto Mori
  • TITakuya Inomoto
    Takuya Inomoto
  • HSHisashi Shinohara
    Hisashi Shinohara
  • SUShinji Uemoto
    Shinji Uemoto
  • YTYukihiko Tokunaga
    Yukihiko Tokunaga
  • YIYukihiro Inomata
    Yukihiro Inomata
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Abstract
We performed 13 pediatric liver transplants from ABO-incompatible living related maternal or paternal donors using a combination of preoperative removal of isohemagglutinin and postoperative immunosuppressive therapy with FK506 and prophylactic OKT3. Tissue near-infrared spectroscopy was applied to evaluate hemodynamics using the hemoglobin of red cells in the sinusoids as an index. The data obtained indicated that the preoperative removal of isohemagglutinin prevented hyperacute humoral rejection with hemorrhagic infiltration in the sinusoids in 10 successful cases. The incidence of acute rejection was not significantly different among ABO-identical, -compatible, and -incompatible groups. The estimated 1-year survival rate of the ABO-incompatible group was 77%.