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Recent advances in ABO incompatible liver transplantation

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Author:
No author available
Journal Title:
World Chinese Journal of Digestology
Issue:
30
DOI:
10.11569/wcjd.v25.30.2665
Key Word:
ABO血型不合肝移植;抗体介导的排斥反应;免疫抑制;胆道并发症;ABO incompatibility liver transplantation;Antibody mediated rejection;Immunosuppression;Biliary complications

Abstract: Liver transplantation has become the best way to cure patients with end-stage liver disease.Due to the shortage of donor organs worldwide and being unable to obtain matched donor liver,most patients with severe hepatic failure lose the chance of operation or even die.As a result,ABO incompatible (ABO-I) liver transplantation has become a choice to save the endangered life.However,compared with ABO compatible liver transplantation,ABO-I liver transplantation is more prone to cause severe antibody mediated rejection (AMR),biliary complications,infection,thrombotic microangiopathy,and acute kidney injury.Consequently,its clinical application is limited.In recent years,with the progress of AMR prevention strategies such as immunoabsorption,plasmapheresis,rituximab,splenectomy,intravenous immunoglobulin,and graft perfusion,the clinical efficacy of ABO-I liver transplantation has been significantly improved,although it still faces the challenge of how to prevent and control AMR and postoperative complications.

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