| Literature DB >> 30070010 |
Krupa R Mysore1, Ryan W Himes1, Abbas Rana2, Jun Teruya3, Moreshwar S Desai4, Poyyapakkam R Srivaths5, Kimberly Zaruca2, Andrea Calvert6, Danielle Guffey7, Charles G Minard7, Eda Morita3, Lisa Hensch3, Michael Losos3, Vadim Kostousov3, Shiu-Ki Rocky Hui3, Jordan S Orange8, John A Goss2, Sarah K Nicholas8.
Abstract
ABO-ILT have re-emerged as an alternate option for select patients awaiting transplant. However, treatment protocols for children undergoing deceased donor ABO-ILT are not standardized. We implemented a novel IS protocol for children undergoing deceased donor ABO-ILT based on pretransplant IH titers. Children with high pretransplant IH titers (≥1:32) underwent an enhanced IS protocol including plasmapheresis, rituximab, IVIG, and mycophenolate, while children with IH titers ≤1:16 received steroids and tacrolimus. We retrospectively assessed our outcomes of ABO-ILT with ABO-compatible recipients of similar age and diagnosis over a 2-year period. Ten children with median age of 8.9 months underwent ABO-ILT, 4 of 10 patients underwent enhanced IS due to high IH titers. Rates of complications (rejection, infections, biliary, and vascular) at both 1 year and up to 3 years post-transplant were comparable between the groups. Patients with ABO-ILT had good graft function with 100% survival at a median follow-up of 3.3 years. In conclusion, IS tailored to pretransplant IH titers in pediatric deceased donor ABO-ILT is feasible and can achieve outcomes similar to ABO-CLT at 1 and 3 years post-transplantation.Entities:
Keywords: ABO incompatible; deceased donor; immunosuppression; isohemagglutinin; liver transplant; pediatric; plasmapheresis
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Year: 2018 PMID： 30070010 PMCID： PMC6197909 DOI： 10.1111/petr.13263
Source DB: PubMed Journal: Pediatr Transplant ISSN： 1397-3142