Adult ABO‐incompatible liver transplantation, using A₂ and B donors

Abstract

The favorable outcome of A2 to O grafting, with a patient survival of 10/10 and a graft survival of 8/10, makes it possible to also consider this blood group combination in non-urgent situations. The use of non-secretor donor grafts is interesting but has to be further documented. There was no hyperacute rejection or increased rate of rejection. Anti-A/B titer changes seem not to play a significant role in the monitoring of ABO-incompatible liver transplantation.

ABO-Incompatible Adult Living Donor Liver Transplantation Under the Desensitization Protocol With Rituximab

“…Mor et al (38) showed a possible link between a high IA titer and AMR, in particular, in A-to-O transplants, whereas Skogsberg et al (39) showed no correlation between a high IA titer and AMR. This may be due to heterogeneity in the direction of the ABO mismatch as well as ABO antigen levels, as may be the case in A-to-O transplants when high IA titers and high levels of antigen expression contribute to a higher risk of AMR.…”

Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience

“…Recently, some authors even report similar outcomes of ABO-incompatible ALDLT as compared to compatible ALDLT [13, 14]. ABO-incompatible ALDLT has subsequently gained acceptance in Europe, namely, in Sweden [15, 16] and Belgium [17]. …”

A2/A2B to B Renal Transplantation: Past, Present, and Future Directions

“…O SLK transplantation. Liver transplantation outcomes, unlike kidney transplant outcomes, are not influenced by high anti-A titers (20,21). Furthermore, an OPTN database study showed that graft survival of 358 A 2 !…”

“…In that review, they also demonstrate histologically that livers from A 2 individuals express much less A antigen in the bile duct, artery, and lymphatic capillaries than do livers from A 1 individuals (19), which may in part also explain the success of A 2 ! O liver (20)(21)(22) and simultaneous liver/ kidney (SLK) transplantation (23).…”