Anaesthetic implications and transfusion practices in ABO incompatible living donor liver transplantation: Case series.

Indian Journal of Anaesthesia
Sindhu BalakrishnanSudhindran Surendran

Abstract

ABO incompatible liver transplants (ABOi LT) are considered as a life-saving option when compatible donor grafts are unavailable. Fourteen adults (right lobe graft) and three children (left lateral segment/lobe) who underwent ABOi LT from living donors between 2011 and 20 period were analysed for transfusions and desensitisation protocols. All recipients received packed red blood cells (PRBC) of their own group. AB plasma that does not contain any antibody was transfused in eight patients and donor group plasma in others. None of the patients developed transfusion related complications. Plasmapheresis and rituximab/bortezumab desensitisation was practised in 11 patients, only rituximab in four, only plasmapheresis in one, and no treatment in a 1 year child. Rejection was manifest in three patients while nine patients developed infections and sepsis. A working knowledge of the blood and product transfusions in ABOi LT is crucial for the anaesthesiologist. Perioperative management and impact of desensitisation protocol are discussed.

References

Jan 7, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Douglas W HantoJames F Whiting
Nov 14, 2006·Transplantation Proceedings·U SkogsbergL Bäckman
Nov 28, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Emma WatzMichael Uhlin
Mar 29, 2016·Journal of the American College of Surgeons·Abbas RanaJohn A Goss
May 7, 2016·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Viju Kumar BharathanSudhindran Surendran
Dec 22, 2016·Journal of Hepato-biliary-pancreatic Sciences·Hiroto EgawaShinji Uemoto
Mar 9, 2019·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Surumi ShajahanUma Devi Padma
Apr 24, 2019·International Reviews of Immunology·Ulrika Skogsberg Dahlgren, William Bennet

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