ABO incompatible liver transplantation in acute and acute on chronic liver failure

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dc.authorid110105en_US
dc.contributor.authorYılmaz, Sezai
dc.contributor.authorAydın, Cemalettin
dc.contributor.authorIşık, Burak
dc.contributor.authorKayaalp, Cüneyt
dc.contributor.authorYılmaz, Mehmet
dc.contributor.authorAra, Cengiz
dc.contributor.authorKutlu, Ramazan
dc.contributor.authorBayındır, Yaşar
dc.contributor.authorErsan, Veysel
dc.date.accessioned2017-08-08T06:59:38Z
dc.date.available2017-08-08T06:59:38Z
dc.date.issued2013
dc.departmentİnönü Üniversitesien_US
dc.description.abstractABO-incompatible (ABO-I) liver transplantation (LTx) is an inevitable problem in emergency conditions such as acute liver failure or acute-on-chronic liver failure when deceased donor (DD) is not available or living donor (LD) selection is limited. This study spesifically addressed the problem of emergency ABO-I LTx in critically ill adult patients having acute liver failure or severely decompensated end stage liver disease. Methodology: This series included 16 patients, of which 10 underwent ABO-I LD LTx and 6 patients underwent 7 ABO-I DD LTx. Two patients underwent ABO-compatible LD LT before ABO-I DD LT, because of hepatic artery thrombosis. Multiple sessions of plasmapheresis were used to reduce isoaglutinin titres to 1/16 or below before and after the transplantation. Splenectomy was carried out after the graft reperfusion in the last 7 cases. In the first 9 patients splenic artery ligation was performed. Data were prospectively collected and retrospectively analysed. Results: The follow-up period ranged from 1 to 38 months. The mean follw-up period was 10.37 months. Median age of patients was 50 years (17-63 years). The MELD scores ranged from 17 to 30 (median 22.5). Median survival of patients was 9 months and mean survival was 19.5 months. Hospital mortality consisted of 3 patients (18.7 %). Two patients died due to small for size graft syndrome and cerebrovascular bleeding respectively. Hepatic artery thrombosis developed in 3 patients. Two of them died at postoperative 4th and 9th months. Third patient is stil living with hepatic necrosis problem. Conclusion: ABO-I LTx remains an important and unavoidable therapeutic option in adult patients with acute or acute-on-chronic liver failure awaiting an emergency procedure and in the context of living donor liver transplantation. This option should be offered to all patients in cases of immediate need for an allograft without the possibility to allocate a blood group compatible liver graft.en_US
dc.identifier.citationYılmaz, S. Aydın, C. Işık, B. Kayaalp, C. Yılmaz, M. Ara, C. Kutlu, R. Bayındır, Y. Ersan, V. (2013). ABO incompatible liver transplantation in acute and acute on chronic liver failure. Hepato-gastroenterology. 60(125), 1189–1193.en_US
dc.identifier.doi10.5754/hge11289en_US
dc.identifier.endpage1193en_US
dc.identifier.issue125en_US
dc.identifier.startpage1189en_US
dc.identifier.urihttps://hdl.handle.net/11616/7481
dc.identifier.volume60en_US
dc.language.isoenen_US
dc.publisherHepato-gastroenterologyen_US
dc.relation.ispartofHepato-gastroenterologyen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectABO incompatibleen_US
dc.subjectAcuteen_US
dc.subjectAcute-on-chronicen_US
dc.subjectLiver failureen_US
dc.subjectLiver transplantationen_US
dc.titleABO incompatible liver transplantation in acute and acute on chronic liver failureen_US
dc.typeArticleen_US

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