| Literature DB >> 35535085 |
Somashekara Hosaagrahara Ramakrishna1, Mohan Babu Kasala2, Karnan Perumal2, Selvakumar Malleeswaran3, Rajanikanth V Patcha4, Joy Varghese5, Malathy Sathiyasekaran6, Mettu Srinivas Reddy4.
Abstract
ABO-incompatible living donor liver transplantation (ABOi-LDLT) is on the rise as a viable option in countries with limited access to deceased donor grafts. While reported outcomes of ABOi-LT in children are similar to ABO- Compatible liver transplant (ABOc-LT), most children beyond 1-2 years of age will need desensitization to overcome the immunological barrier of incompatible blood groups. The current standard protocol for desensitization is Rituximab that targets B lymphocytes and is given 2-3 weeks prior to LT. However, this timeline may not be feasible in children requiring emergency LT for acute liver failure (ALF) or acute-on-chronic liver failure (ACLF). In this emergency situation of ABOi-LT, a safe multipronged approach may be an acceptable alternative solution. We report a child with acute Wilson's disease with rapidly deteriorating liver function who underwent a successful ABOi-LDLT using a rapid desensitization protocol.Entities:
Keywords: ABOc-LT, ABO-compatible liver transplantation (ABOi-LDLT); ABOi-LDLT, ABO-incompatible living donor liver transplantation; ACLF, Acute-on-chronic liver failure; ALF, Acute liver failure; AMR, Antibody-mediated rejection; CMV, Cytomegalovirus; CSF, Cerebrospinal fluid; GRWR, Graft-to-recipient weight ratio; LDLT, Living donor liver transplantation; LT, Liver transplant; MMF, Mycophenolate mofetil; PVT, Portal vein thrombosis; Rituximab; acute Wilson’s disease; acute-on-chronic liver disease; emergency ABOi-LDLT; living donor liver transplantation
Year: 2021 PMID： 35535085 PMCID： PMC9077158 DOI： 10.1016/j.jceh.2021.08.008
Source DB: PubMed Journal: J Clin Exp Hepatol ISSN： 0973-6883