ABO BLOOD-GROUP INCOMPATIBILITY IN LIVER-TRANSPLANTATION - A SINGLE-CENTER EXPERIENCE

Background: For most organ transplantation (Tx), ABO blood group incom patibility (ABOI) is an absolute contraindication because of the high incidence of hyperacute rejection (HAR). While HAR occurs in ABOI Live r Tx (LTx), it is known that some liver grafts can be accepted. Method s: ABO-incompatible (ABOI) liver allografts were used in seven of 355 orthotopic LTx operations performed at our institution over a 10-year period. All seven recipients were in fulminant hepatic failure (FHF) p rior to Tx. Results: Following Tx, all grafts functioned immediately. One patient died without recovering consciousness. Six patients recove red consciousness following Tx but three patients subsequently require d re-transplantation (with ABO-compatible grafts (ABOC)) because of se vere acute rejection (2) and chronic rejection (1). Hyper-acute reject ion did not occur. All six patients are now well, with a mean survival of 61.5 months. When compared to 36 other FHF patients who received A BOC grafts, graft survivals were 3/7 (43%) for ABOI versus 23/36 (64%) for ABOC (P = not significant (NS)). Patient survivals were 6/7 (85.7 %) for ABOI patients and 23/36 (64%) for ABOC (P = NS). The re-transpl antation rate was significantly higher in the ABOI group (P = 0.001). Conclusions: The results confirm that ABOI liver grafts should be used in urgent circumstances when compatible grafts are not available. Som e grafts function indefinitely, while those that fail may function for sufficient time to allow successful retransplantation with ABOC graft s.