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Efficacy of single, extended and goal directed immunoadsorption in ABO incompatible living related donor liver transplantation
- Source :
- Transfusion and Apheresis Science. 55:329-332
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Background Liver transplantation is one of the solid organs most commonly being transplanted across the world. The indications, affordability and accessibility have grown manifold. To increase the donor pool, inclusion of ABO incompatible liver donors is being considered. To enhance the graft functioning and survival, immunoadsorption apheresis to reduce the ABO hemagglutination titres are on the rise. Case Report We report three cases ABO incompatible liver transplantation with immunoadsorption protocol. The patients were in poor general condition with Child-Turcotte-Pugh (CTP) class āCā and there were no suitable ABO compatible grafts at the time. For all three cases, immunosuppressive protocol consisted of induction with Rituximab, followed by tacrolimus, mycophenolate mofetil and corticosteroids. The third patient received basiliximab for induction, in addition to the above protocol. First 2 patients received 1 immunoadsorption (IA) session with Glycosorb ABO® system (Glycorex AB, Sweden), pre-operatively. The third patient received 2 IA sessions pre-operatively. Baseline IgM plus IgG titres were 1024; 64 and 1024 for anti-B, anti-A and anti-B for patient 1, 2 and 3 respectively. Target pre-operative antibody titre was ā¤16. Average post-operative length of stay was 17.3 days. There were no acute rejection. None of them, required any post-operative plasma exchange. Conclusion Immunoadsorption is effective in reducing hemagglutination titres in recipients of ABO incompatible donor liver.
- Subjects :
- Male
medicine.medical_specialty
Basiliximab
medicine.medical_treatment
030204 cardiovascular system & hematology
Liver transplantation
ABO Blood-Group System
03 medical and health sciences
0302 clinical medicine
ABO blood group system
Living Donors
Humans
Medicine
Immunoadsorption
biology
business.industry
Hematology
Middle Aged
Tacrolimus
Liver Transplantation
Surgery
Treatment Outcome
Apheresis
Blood Group Incompatibility
biology.protein
Female
030211 gastroenterology & hepatology
Rituximab
Adsorption
Antibody
business
Goals
medicine.drug
Subjects
Details
- ISSN :
- 14730502
- Volume :
- 55
- Database :
- OpenAIRE
- Journal :
- Transfusion and Apheresis Science
- Accession number :
- edsair.doi.dedup.....63cb506c62b2d6cdb04694ab0ac67a81