The role of immunomodulation in ABO-incompatible adult liver transplant recipients

Journal of Clinical Apheresis
Lucio UrbaniFranco Filipponi

Abstract

ABO-incompatible (ABO-i) liver transplantation (LT) is a high-risk procedure due to the potential for antibody-mediated rejection (AMR) and cell-mediated rejection. The aim of the current report is to illustrate the results of a retrospective comparison study on the use of immunomodulation with therapeutic plasma exchange (TPE) associated to high-dose immunoglobulins (IVIg) and extracorporeal photopheresis (ECP) in ABO-i adult LT patients. Between January 1996 and December 2005, 19 patients underwent ABO-i LT. The study was designed for a comparison between two groups of ABO-i LT. Group 1 (control group) consisted of 11 patients treated with TPE only. Group 2 (study group) included eight patients treated with TPE and IVIg. Moreover, all Group 2 patients received acute rejection prophylaxis with ECP. The graft survival at 6, 12, and 18 months was 63.6, 54.4, and 45.5% for Group 1 vs. 87.5, 87.5, and 87.5% for Group 2 (P < or = 0.001). In Group 1 there were 3(27.3%) cases of AMR; 5 (45.4%) biopsy-proven acute rejections (BPAR); 1 (9.1%) chronic rejection and 3 (27.3%) ischemic-type biliary lesions (ITBL). In Group 2 there were no cases of AMR, BPAR, chronic rejection, or ITBL (P = 0.013). At median follow-up of 568 days, TPE in c...Continue Reading

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Citations

Apr 25, 2012·Journal of Transplantation·Raffaele Cursio, Jean Gugenheim
Jan 29, 2014·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Seung Duk LeeSang-Jae Park
Sep 25, 2015·The Journal of Medical Investigation : JMI·Mitsuhiro YasudaYoshihiko Maehara
Jun 17, 2008·Transplantation Proceedings·L UrbaniF Filipponi
Mar 5, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Trygve ThorsenWilliam Bennet
Jan 30, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Jian ZhouXiaoshun He
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Sep 30, 2016·World Journal of Transplantation·Silke RummlerUtz Settmacher
Nov 1, 2017·World Journal of Gastroenterology : WJG·Eung Chang LeeSang-Jae Park
Jan 15, 2013·Anesthesiology·Sloan C YoungbloodCharles D Collard
Oct 11, 2019·World Journal of Transplantation·Rodrigo S FigueiredoColin H Wilson
Oct 21, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Seong Hoon KimSang Jae Park

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