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Lee B, Cho JY, Han HS, et al. Long-term outcomes of emergency ABO-incompatible living donor liver transplantation using a modified desensitization protocol for highly sensitized patients with acute liver failure: A case report. Ann Hepatobiliary Pancreat Surg. 2021;25(4):571-574doi: 10.14701/ahbps.2021.25.4.571.
Lee, B., Cho, J. Y., Han, H. S., Yoon, Y. S., Lee, H. W., Lee, J. S., Kim, M., & Choi, Y. (2021). Long-term outcomes of emergency ABO-incompatible living donor liver transplantation using a modified desensitization protocol for highly sensitized patients with acute liver failure: A case report. Annals of hepato-biliary-pancreatic surgery, 25(4), 571-574. https://doi.org/10.14701/ahbps.2021.25.4.571
Lee, Boram, et al. "Long-term outcomes of emergency ABO-incompatible living donor liver transplantation using a modified desensitization protocol for highly sensitized patients with acute liver failure: A case report." Annals of hepato-biliary-pancreatic surgery vol. 25,4 (2021): 571-574. doi: https://doi.org/10.14701/ahbps.2021.25.4.571
Lee B, Cho JY, Han HS, Yoon YS, Lee HW, Lee JS, Kim M, Choi Y. Long-term outcomes of emergency ABO-incompatible living donor liver transplantation using a modified desensitization protocol for highly sensitized patients with acute liver failure: A case report. Ann Hepatobiliary Pancreat Surg. 2021 Nov 30;25(4):571-574. doi: 10.14701/ahbps.2021.25.4.571. PMID: 34845134; PMCID: PMC8639309.
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Ann Hepatobiliary Pancreat Surg. 2021 Nov 30;25(4):571-574. doi: 10.14701/ahbps.2021.25.4.571.

Long-term outcomes of emergency ABO-incompatible living donor liver transplantation using a modified desensitization protocol for highly sensitized patients with acute liver failure: A case report.

Annals of hepato-biliary-pancreatic surgery

Boram Lee, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, Hae Won Lee, Jun Suh Lee, Moonhwan Kim, YoungRok Choi

Affiliations

  1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  2. Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

PMID: 34845134 PMCID: PMC8639309 DOI: 10.14701/ahbps.2021.25.4.571

Abstract

Although there is no established desensitization protocol for liver transplantation (LT), desensitization usually entails treatment with rituximab, plasmapheresis, splenectomy, and intravenous immunoglobulin (IVIG) infusion together with a local graft. The desensitization protocol is usually initiated 2 to 3 weeks before transplantation. Therefore, patients with acute liver failure warranting urgent LT are usually ineligible for ABO-incompatible (ABOi) LT. For these reasons, several attempts have been made to abridge the desensitization protocol and extend the indication for ABOi living donor LT (LDLT). Here we report a 40-year-old female diagnosed with chronic hepatitis B and acute-on-chronic liver failure (model for end-stage liver disease score, 31). In the absence of a suitable compatible liver donor, emergency ABOi LT was planned using a modified desensitization protocol. The preoperative isoagglutinin (IA) titer was 1 : 1,024 and the preoperative T- and B-cell cross-matches were positive. The patient received a single dose of rituximab (375 mg/m

Keywords: Graft rejection; Immunoglobulins, intravenous; Liver failure, acute; Liver transplantation

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