Dong-Hwan Jung1, Shin Hwang, Chul-Soo Ahn, Ki-Hun Kim, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Gil-Chun Park, Sung-Gyu Lee. 1. 1 Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 2 Address correspondence to: Sung-Gyu Lee, M.D., Ph.D., F.A.C.S., Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea.
Abstract
BACKGROUND: An exchange living donor program for liver transplantation, similar to the exchange living donor kidney program, was proposed to avoid ABO-incompatible adult living donor liver transplantation (LDLT). The objective of this study was to present updated changes in exchange adult LDLT program at our institution. METHODS: Between January 2003 and December 2011, approximately 2,182 adult LDLT cases were included in this study. During this period, 26 paired-exchange donor LDLT cases were performed (1.2%). RESULTS: Of the 26 paired-exchange donor LDLT cases, 22 pairs were matched due to ABO-incompatibility, and 4 pairs were matched because of cascade allocation of unrelated donors or relatively small graft volume to the recipients. A total of 28 living donors were included in the 26 paired-exchange donor LDLT cases because of inclusion of two dual-graft transplants. Elective surgery was performed in 22 cases, and urgent operation was performed in 4 cases. The overall 1-year and 5-year patient and graft survivals were both 96.2% and 90.1%, respectively. CONCLUSIONS: Our experience suggests that the paired-exchange donor program for adult LDLT seems to be a feasible modality to overcome donor ABO incompatibility. Reasonably acceptable indications for donor exchange LDLT will be proposed in near future.
BACKGROUND: An exchange living donor program for liver transplantation, similar to the exchange living donor kidney program, was proposed to avoid ABO-incompatible adult living donor liver transplantation (LDLT). The objective of this study was to present updated changes in exchange adult LDLT program at our institution. METHODS: Between January 2003 and December 2011, approximately 2,182 adult LDLT cases were included in this study. During this period, 26 paired-exchange donor LDLT cases were performed (1.2%). RESULTS: Of the 26 paired-exchange donor LDLT cases, 22 pairs were matched due to ABO-incompatibility, and 4 pairs were matched because of cascade allocation of unrelated donors or relatively small graft volume to the recipients. A total of 28 living donors were included in the 26 paired-exchange donor LDLT cases because of inclusion of two dual-graft transplants. Elective surgery was performed in 22 cases, and urgent operation was performed in 4 cases. The overall 1-year and 5-year patient and graft survivals were both 96.2% and 90.1%, respectively. CONCLUSIONS: Our experience suggests that the paired-exchange donor program for adult LDLT seems to be a feasible modality to overcome donorABO incompatibility. Reasonably acceptable indications for donor exchange LDLT will be proposed in near future.
Authors: Hillary J Braun; Ana M Torres; Finesse Louie; Sandra D Weinberg; Sang-Mo Kang; Nancy L Ascher; John P Roberts Journal: Am J Transplant Date: 2020-12-08 Impact factor: 8.086