Outcomes after identical and compatible orthotopic liver transplantation for fulminant hepatic failure: a single center experience in UK

Koukoutsis, Ilias; Bellagamba, Riccardo; Tamijmarane, A.; Gunson, Bridget K.; Muralidharan, Vijayaragavan; Wigmore, Stephen J.; Mayer, David; Mirza, Darius F.; Buckels, J. A. C.; Bramhall, Simon R.

doi:10.1111/j.1432-2277.2007.00458.x

Cited by 10 publications

(10 citation statements)

References 23 publications

(35 reference statements)

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“…Studies that involved urgent indica-tions[ 15 , 17 , 19 , 20 , 33 , 34 , 39 , 40 , 42 ] had worse 1-year graft survival (OR = 0.37, 95%CI: 0.23-0.59 vs OR=0.70, 95%CI: 0.61-0.81; P = 0.01) but better 5-year patient survival (OR = 2.38, 95%CI: 0.86-6.63 vs OR = 0.79, 95%CI: 0.57-1.08, P = 0.043) for ABO-I LT than those for ABO-CT when compared to studies without urgent indications.…”

Section: Resultsmentioning

confidence: 99%

Outcomes after liver transplantation in accordance with ABO compatibility: A systematic review and meta-analysis

Lee

Kim

Park

2017

WJG

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AIMTo evaluate the differences in outcomes between ABO-incompatible (ABO-I) liver transplantation (LT) and ABO-compatible (ABO-C) LT.METHODSA systematic review and meta-analysis were performed by searching eligible articles published before No-vember 28, 2016 on MEDLINE (PubMed), EMBASE, and Cochrane databases. The primary endpoints were graft survival, patient survival, and ABO-I-related complications.RESULTSTwenty-one retrospective observational studies with a total of 8247 patients were included in this meta-analysis. Pooled results of patient survival for ABO-I LT were comparable to those for ABO-C LT. However, ABO-I LT showed a poorer graft survival than ABO-C LT (1-year: OR = 0.66, 95%CI: 0.57-0.76, P < 0.001; 3-year: OR = 0.74, 95% CI 0.64-0.85, P < 0.001; 5-yearr: OR =0.75, 95%CI: 0.66-0.86, P < 0.001). Furthermore, ABO-I LT was associated with more incidences of antibody-mediated rejection (OR = 74.21, 95%CI: 16.32- 337.45, P < 0.001), chronic rejection (OR =2.28, 95%CI: 1.00-5.22, P = 0.05), cytomegalovirus infection (OR = 2.64, 95%CI: 1.63-4.29, P < 0.001), overall biliary complication (OR = 1.52, 95%CI: 1.01-2.28, P = 0.04), and hepatic artery complication (OR = 4.17, 95%CI: 2.26-7.67, P < 0.001) than ABO-C LT. In subgroup analyses, ABO-I LT and ABO-C LT showed a comparable graft survival in pediatric patients and those using rituximab, and ABO-I LT showed an increased acute cellular rejection in cases involving deceased donor grafts.CONCLUSIONAlthough patient survival in ABO-I LT was comparable to that in ABO-C LT, ABO-I LT was inferior to ABO-C LT in graft survival and several complications. Graft survival of ABO-I LT could be comparable to that of ABO-C LT in pediatric patients and those using rituximab.

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Section: Resultsmentioning

confidence: 99%

Outcomes after liver transplantation in accordance with ABO compatibility: A systematic review and meta-analysis

Lee

Kim

Park

2017

WJG

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“…Some studies have reported no statistical difference in graft survival, while others have demonstrated that patient survival is less in ABOcompatible recipients compared to ABO-identical recipients. ABO-identical OLT is still preferred (Aladag et al, 2006;Bjoro et al, 2003;Koukoutsis et al, 2007); Smith et al, 2000).…”

Section: Abo-incompatible Graftsmentioning

confidence: 99%

Role of Liver Transplantation in Acute Liver Failure

Liou

Larson

2008

Semin Liver Dis

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“…Possibly due to the fact that kidney transplant contains fewer GVH antibodies and GVH antibody-producing cells, GVH antibody-induced hemolytic anemia was mild and does not cause serious consequences in kidney transplantation. In liver transplantation, with presumably more GVH antibodies or GVH antibody-producing cells, Koukoutisis [6] and Bjoro [7] reported that ABO-compatible transplant recipients have significantly lower graft and patient survival compared to ABO-identical transplant patients. The intestine possesses the largest mass of lymphoid tissue of any solid organ in the human body [15].…”

Section: Discussionmentioning

confidence: 99%

Is ABO-Compatible but Non-Identical Intestinal Transplant Comparable to ABO-Identical Transplant? An Analysis of the UNOS Registry

Cai¹

2015

SOJI

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SOJ ImmunologyOpen Access Research Article survival in the heart [1,2], lung [3,4], and liver [5] transplants. However, careful investigation of these studies demonstrates that ABO-compatible transplants have lower graft survival than identical transplants in some of these studies, though the differences do not reach statistical significance. Koukoutisis [6] and Bjoro [7] reported that ABO-compatible liver transplant recipients actually have significantly lower graft and patient survival than ABO-identical transplant patients.Compared to other organ transplantation, intestinal transplantation remains the least frequently performed transplantation. There are more than 40 US centers performing intestinal transplants and case numbers in recent years were only around 100 per year in the US, with most centers performing fewer than 10 transplants per year [8]. With limited intestinal transplant cases, it is very difficult or it may take a long time for a single center to provide convincing evidence to show whether ABO-compatible and identical transplants have comparable graft outcome, especially long-term outcome. Our recent analysis demonstrated that during 1990-2013, 9.7% of US intestinal recipients received transplants from ABO-compatible donors. More importantly, we found there was a very significant increasing trend of ABO-compatible intestinal transplants in recent years (from 4% to 16%). These findings make it urgent to know whether it is safe to perform ABO-compatible intestinal transplantation and what we should do to minimize the potential risk if the ABO-compatible transplant is associated with graft failure. By analyzing US national registry data, we show the current status of ABO-compatible intestinal transplantation in the US and its detrimental effects on short-and long-term intestinal allograft outcomes. We also discuss the potential mechanisms of graft-versus-host reaction-induced graft injury and corresponding strategies. Materials and Methods Study populationBetween 1/1/1990 and 6/27/2013, a total of 2,287 US intestinal transplants were reported to the Organ Procurement Absract ABO-compatible intestinal transplants have been more frequently performed in the US in recent years (from 4% to 16%). However, they have not been clearly shown to have comparable short-and long-term graft outcome compared to ABO-identical transplants.The US national registry database was analyzed to show the current status of ABO-compatible intestinal transplantation and to determine its effect on acute rejection and long-term graft survival.Blood type A, B, and AB patients received 11%, 26%, and 62% of ABO-compatible intestinal transplants, respectively. ABO-compatible transplant recipients experienced a higher rate of acute rejection than ABO-identical patients (77% vs. 64%, p < 0.0001). In addition, they had a significantly lower 10-year graft survival rate than ABO-identical transplant recipients (27% vs. 35%, p = 0.020). Acute rejection was the cause of graft failure in 42% of ABO-compatible and 25% of ABOidentical pat...

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Outcomes after identical and compatible orthotopic liver transplantation for fulminant hepatic failure: a single center experience in UK

Cited by 10 publications

References 23 publications

Outcomes after liver transplantation in accordance with ABO compatibility: A systematic review and meta-analysis

Outcomes after liver transplantation in accordance with ABO compatibility: A systematic review and meta-analysis

Role of Liver Transplantation in Acute Liver Failure

Is ABO-Compatible but Non-Identical Intestinal Transplant Comparable to ABO-Identical Transplant? An Analysis of the UNOS Registry

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