Outcome of ABO-incompatible adult living-donor liver transplantation for patients with hepatocellular carcinoma

Yoon, Yong Sik; Song, Gi Won; Lee, Sung Gyu; Hwang, Shin; Kim, Ki Hun; Kim, Seok Hwan; Kang, Woo‐Hyoung; Cho, Hwui Dong; Jwa, Eunkyoung; Kwon, Jae Hyun; Tak, Eun Young; Kirchner, Varvara A.

doi:10.1016/j.jhep.2018.02.002

Cited by 37 publications

(31 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although we identified 9 studies for inclusion in the analysis, two of the studies (study nos. 1 and 2) [25, 26] identified were from the same institutions in Korea as those of study nos. 3 and 4 [27, 28].…”

Section: Resultsmentioning

confidence: 99%

“…However, the MELD score and the maximum tumor diameter were significantly lower in ABOi ALDLT for patients with HCC, probably because of the careful patient selection for ABOi ALDLT. Both the studies reporting on the recurrence of HCC for ABOi ALDLT revealed that rituximab does not increase the risk of HCC recurrence [25, 26]. Nevertheless, it has been found that overexposure to tacrolimus and basiliximab during the first year after LT increases the risk of HCC recurrence [52, 53].…”

Section: Discussionmentioning

confidence: 99%

“…Meta-analyses of the outcome for ABOi ALDLT for patients with HCC are shown in Supplementary Figure 1. To assess the outcome measurement of ABOi ALDLT for patients with HCC, a total of 1,158 patients were incorporated in 2 studies [25, 26]. A meta-analysis using a fixed-effect model revealed that there was no significant difference in preoperative AFP level (SMD: -5.96, 95% CI: -238.26 to 226.34, P = 0.96, Supplementary Figure 1(a)) between the ABOi and ABOc groups for patients with HCC.…”

Section: Meta-analysismentioning

confidence: 99%

See 2 more Smart Citations

ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis

Yadav

Hua

Bai

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Aim. The primary aim of this study is to compare the short- and long-term outcomes between ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) with rituximab prophylaxis and ABO-compatible (ABOc) ALDLT. Background. The strategy of ABOi liver transplantation (LT) was originated initially to increase the donor pool and to enable liver transplantation in emergency conditions. However, ABOi ALDLT remains a controversial approach in comparison to ABOc ALDLT. Methods. PubMed, Embase, and the Cochrane Library study search were accomplished to recognize studies comparing ABOi and ABOc ALDLT. Meta-analyses were conducted based on the evaluation of heterogeneity using a fixed-effect model and a random-effect model to assess the short- and long-term outcomes following ABOi ALDLT with rituximab prophylaxis. Results. Nine studies comprising a total of 3,922 patients (ABOi=671 and ABOc=3,251) were identified. There was no significant difference between ABOi and ABOc groups for 1-year, 3-year, and 5-year OS and graft survival, respectively. Moreover, 1-year and 3-year OS and DFS were similar between both groups for HCC patients. However, ABOi ALDLT had higher incidences of CMV infection, AMR, overall biliary complications, and biliary stricture than ABOc ALDLT and had other comparable postoperative complications. Conclusion. Our meta-analysis included studies comparing ABOi and ABOc ALDLT after the introduction of rituximab in a desensitization protocol for ABOi ALDLT. The results of ABOi ALDLT were comparable with those of ABOc ALDLT. However, biliary complications, CMV infection, and AMR remain a concern in the era of rituximab.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Meta-analysismentioning

confidence: 99%

See 1 more Smart Citation

ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis

Yadav

Hua

Bai

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…Propensity score match study had shown comparable recurrence-free survival rates and overall patient-survival outcomes between ABO-I LDLT and ABO-C LDLT groups. 34…”

Section: Discussionmentioning

confidence: 99%

Immunologic strategies and outcomes in ABO-incompatible living donor liver transplantation

Kim

2020

Clin Mol Hepatol

View full text Add to dashboard Cite

In the past, adult ABO incompatible living donor liver transplantation (ABO-I LDLT) had poor graft survival and low patient survival due to hyperacute rejection and a high risk of vascular biliary complication, and it was considered a contraindication. 1-4 Susceptibility to rejection, including severe hepatic necrosis and diffuse intravascular coagulation disorder within the graft, appears to be due to the blood group antigen expressed in the vascular endothelium and bile ducts after transplantation. 5,6 Various desensitization strategies have been introduced to overcome the barrier of ABO incompatibility. 7-9 However, desensitization protocols differ at each center, and the necessity of local infusion, splenectomy, intravenous immunoglobulin (IVIG), and plasmapheresis is controversial. After the rituximab era, the outcome of ABO-I LDLT has been reported in many studies to be comparable to ABO compatible living donor liver transplantation (ABO-C LDLT). 10-13 Many centers are now trying to simplify protocols. 14-20 We review the past and current immune strategies for desensitization and to provide outcomes and ABO incompatibility-related complications in ABO-I LDLT.

show abstract

“…Despite serious complications, ABO-incompatible LDLT can be a feasible option for patients if certain essential treatments are included[ 89 , 90 ]. Rituximab, an anti-CD20 immunoglobulin (IgG)1 terminating B-lymphocytes with an affinity for IgG Fc receptor (FcγR), is a critical strategy in the regimens for desensitization for ABO-incompatible LDLT and yields outcomes for ABO-incompatible LDLT that are similar to those for ABO-compatible LDLT[ 91 , 92 ].…”

Section: Abo-incompatible Ldltmentioning

confidence: 99%

Feasibility of using marginal liver grafts in living donor liver transplantation

Xiang

Zhang

et al. 2018

WJG

View full text Add to dashboard Cite

Liver transplantation (LT) is one of the most effective treatments for end-stage liver disease caused by related risk factors when liver resection is contraindicated. Additionally, despite the decrease in the prevalence of hepatitis B virus (HBV) over the past two decades, the absolute number of HBsAg-positive people has increased, leading to an increase in HBV-related liver cirrhosis and hepatocellular carcinoma. Consequently, a large demand exists for LT. While the wait time for patients on the donor list is, to some degree, shorter due to the development of living donor liver transplantation (LDLT), there is still a shortage of liver grafts. Furthermore, recipients often suffer from emergent conditions, such as liver dysfunction or even hepatic encephalopathy, which can lead to a limited choice in grafts. To expand the pool of available liver grafts, one option is the use of organs that were previously considered “unusable” by many, which are often labeled “marginal” organs. Many previous studies have reported on the possibilities of using marginal grafts in orthotopic LT; however, there is still a lack of discussion on this topic, especially regarding the feasibility of using marginal grafts in LDLT. Therefore, the present review aimed to summarize the feasibility of using marginal liver grafts for LDLT and discuss the possibility of expanding the application of these grafts.

show abstract

Outcome of ABO-incompatible adult living-donor liver transplantation for patients with hepatocellular carcinoma

Cited by 37 publications

References 30 publications

ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis

ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis

Immunologic strategies and outcomes in ABO-incompatible living donor liver transplantation

Feasibility of using marginal liver grafts in living donor liver transplantation

Contact Info

Product

Resources

About