Increasing Living Donor Liver Transplantation Using Liver Paired Exchange.
ABO Blood-Group System
Adolescent
Adult
Aged
Blood Group Incompatibility
COVID-19
/ mortality
Cause of Death
Female
Humans
Kidney
Liver Transplantation
/ statistics & numerical data
Living Donors
/ statistics & numerical data
Male
Middle Aged
Postoperative Complications
/ etiology
Retrospective Studies
Tissue and Organ Procurement
/ methods
Transplant Recipients
/ statistics & numerical data
Young Adult
Journal
Journal of the American College of Surgeons
ISSN: 1879-1190
Titre abrégé: J Am Coll Surg
Pays: United States
ID NLM: 9431305
Informations de publication
Date de publication:
01 Feb 2022
01 Feb 2022
Historique:
entrez:
25
2
2022
pubmed:
26
2
2022
medline:
5
3
2022
Statut:
ppublish
Résumé
Living donor liver transplantation (LDLT) continues to be the primary modality of liver transplantation in Asia, but it accounts for about 5% of all liver transplantations in the US. ABO incompatibility is the primary reason motivated donors are declined. Although kidney paired exchanges are common, liver paired exchange (LPE) is still evolving in the US. This is a retrospective review (between January 1, 2019, and July 31, 2021) of our initial experience with LPE. A total of 10 LPEs (20 LDLTs) were performed during the study period. Seven LPEs were initiated by a nondirected O donor. The other 3 pair sets involved 1 ABO compatible and 1 ABO incompatible pair. Transplantations in a pair set were completed within a mean of 4.8 (range 1-14) days of each other. All 20 donors are doing well with no major complications at 12.7 (range 1-20) months. Seventeen of 20 recipients are alive and have good allograft function. One recipient died in the early postoperative period. Two late deaths of patients with functioning allografts were due to COVID-19 (at 8 months) and peritoneal carcinomatosis and gram-negative sepsis (at 9 months). LPE is feasible in a high-volume LDLT center and is a useful option to increase LDLT by overcoming ABO incompatibility. Nondirected donors can be utilized to initiate an LPE.
Sections du résumé
BACKGROUND
BACKGROUND
Living donor liver transplantation (LDLT) continues to be the primary modality of liver transplantation in Asia, but it accounts for about 5% of all liver transplantations in the US. ABO incompatibility is the primary reason motivated donors are declined. Although kidney paired exchanges are common, liver paired exchange (LPE) is still evolving in the US.
STUDY DESIGN
METHODS
This is a retrospective review (between January 1, 2019, and July 31, 2021) of our initial experience with LPE.
RESULTS
RESULTS
A total of 10 LPEs (20 LDLTs) were performed during the study period. Seven LPEs were initiated by a nondirected O donor. The other 3 pair sets involved 1 ABO compatible and 1 ABO incompatible pair. Transplantations in a pair set were completed within a mean of 4.8 (range 1-14) days of each other. All 20 donors are doing well with no major complications at 12.7 (range 1-20) months. Seventeen of 20 recipients are alive and have good allograft function. One recipient died in the early postoperative period. Two late deaths of patients with functioning allografts were due to COVID-19 (at 8 months) and peritoneal carcinomatosis and gram-negative sepsis (at 9 months).
CONCLUSIONS
CONCLUSIONS
LPE is feasible in a high-volume LDLT center and is a useful option to increase LDLT by overcoming ABO incompatibility. Nondirected donors can be utilized to initiate an LPE.
Identifiants
pubmed: 35213430
doi: 10.1097/XCS.0000000000000036
pii: 00019464-202202000-00003
doi:
Substances chimiques
ABO Blood-Group System
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
115-120Informations de copyright
Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
Références
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