OP 161. AB0 Incompatible Liver Transplantation – The Czech Experience

J. Froněk, Janoušek, M. Oliverius, Kučera, Kieslichova, Viklický, Trunečka

Chair(s): Jiri Fronek, Mehmet Erikoglu & Mátyás Kiss

8:50 - 9:00h at Buda Room (B)

Categories: Oral Session, Organ and Cell Transplantation

Session: Oral Session XVIII - Organ and Cell Transplantation II

Background
The AB0-incompatible liver transplantation (LTx) is alternative method which can be used in some of the fulminant liver failure (FLF) cases, in some countries even for elective transplants. For overcoming the blood group barrier various techniques can be used.

Material and Methods
Czech Republic is country with 10 million inhabitans and some 200 deceased donors per year. At our institution we perform over 80 liver transplants every year, we did 87 LTx in 2013, our LTx program counts over 1000 LTx since 1995. To increase the chance for survival, in some of the fulminant liver failure cases we used the AB0i graft. In first 6 cases we used plasma- exchange, in last one non-specific immunoadsorption.

Results
In total 7 patients received AB0i liver graft, 2/7 received hemiliver, 2/7 died shortly after the LTx, none due to the the incompatibility-related problems, 1/7 was re-transplanted 16.POD, 5/7 patients are alive with well functioning graft (see table 1). 

Conclusion
In a small country with limited number of liver grafts per year, the AB0i liver transplantation is justified in FLF setting. Such technique gives reasonable chance for survival, the final outcome depends on severity of the FHF as well as primary diagnosis. Both apheretic as well as plasma- based techniques can be used with success to overcome the AB0i barrier. Both full size and hemiliver grafts can be used for transplant, the last case was full split liver for two adults because two FHF patients occurred at the same time, both these two patients (husband and wife) are alive and well. 

Table 1.

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