دورية أكاديمية
أعرض في EDS

Outcomes after ABO incompatible pediatric liver transplantation are comparable to ABO identical/compatible transplant.

التفاصيل البيبلوغرافية
العنوان: Outcomes after ABO incompatible pediatric liver transplantation are comparable to ABO identical/compatible transplant.
المؤلفون: Lemoine CP; Division of Transplant and Advanced Hepatobiliary Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States., Brandt KA; Division of Transplant and Advanced Hepatobiliary Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States., Keswani M; Division of Nephrology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States., Superina R; Division of Transplant and Advanced Hepatobiliary Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
المصدر: Frontiers in pediatrics [Front Pediatr] 2023 May 31; Vol. 11, pp. 1092412. Date of Electronic Publication: 2023 May 31 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101615492 Publication Model: eCollection Cited Medium: Print ISSN: 2296-2360 (Print) Linking ISSN: 22962360 NLM ISO Abbreviation: Front Pediatr Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Lausanne : Frontiers Media SA, [2013]-
مستخلص: Background: ABO incompatible (ABOi) liver transplantation (LT) was initially associated with a higher incidence of vascular, biliary, and rejection complications and a lower survival than ABO compatible (ABOc) LT. Various protocols have been proposed to manage anti-isohemagglutinin antibodies and hyperacute rejection. We present our experience with a simplified protocol using only plasmapheresis.
Methods: A retrospective review of all patients who received an ABOi LT at our institution was performed. Comparisons were made based on era (early: 1997-2008, modern: 2009-2020) and severity of disease (status 1 vs. exception PELD at transplant). A pair-matched comparison was done to patients who received an ABOc LT. p  < 0.05 was considered significant.
Results: 17 patients received 18 ABOi LT (3 retransplants). Median age at transplant was 7.4 months (1.1-28.9). 66.7% patients were listed as status 1. Hepatic artery thrombosis (HAT) occurred in one patient (5.6%), there were 2 cases of portal vein thrombosis (PVT) (11.1%), and 2 biliary strictures (11.1%). Patient and graft survival improved in the ABOi modern era, although not significantly. In the pair-matched comparison, complications (HAT p  = 0.29; PVT p  = 0.37; biliary complications p  = 0.15) and survival rates were similar. Patient and graft survivals were 100% in the non-status 1 ABOi patients compared to 67% ( p  = 0.11) and 58% ( p  = 0.081) respectively for patients who were transplanted as status 1.
Conclusion: ABO incompatible liver transplants in infants with a high PELD score have excellent outcomes. Indications for ABO incompatible transplants should be liberalized to prevent deaths on the waiting list or deterioration of children with high PELD scores.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(© 2023 Lemoine, Brandt, Keswani and Superina.)
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فهرسة مساهمة: Keywords: ABO incompatible liver transplantation; isohemagglutinin titers; pediatric liver transplantation; plasmapheresis; vascular and biliary complications
تواريخ الأحداث: Date Created: 20230616 Latest Revision: 20230619
رمز التحديث: 20230620
مُعرف محوري في PubMed: PMC10265869
DOI: 10.3389/fped.2023.1092412
PMID: 37325348
قاعدة البيانات: MEDLINE
الوصف
تدمد:2296-2360
DOI:10.3389/fped.2023.1092412