Potential effect of using ABO-compatible living-donor liver transplantation

Area of Science:

• Transplantation immunology
• Surgical innovation
• Public health policy

Background:

• Liver transplantation rates have risen, but the number of patients awaiting transplants has grown disproportionately.
• The demand for liver transplants has outpaced the supply of deceased donor organs, leading to extended waiting lists.

Purpose of the Study:

• To evaluate the potential impact of ABO-compatible living-donor liver transplantation (LDLT) on liver transplant waiting lists.
• To analyze the effect of LDLT on the overall liver transplantation program and patient outcomes.

Main Methods:

• Mathematical modeling was employed to assess the influence of ABO-compatible LDLT.
• Prevalence data of ABO blood groups in the general population and among potential family donors (parents, siblings) were calculated.
• Probabilities of ABO compatibility for living donors were determined.

Main Results:

• The incidence of ABO compatibility in the general population was O (0.512), A (0.31), B (0.133), and AB (0.04).
• ABO compatibility probabilities for parent donors were A (0.174), O (0.152), B (0.06), and AB (0.03).
• ABO compatibility probabilities for sibling donors were O (0.354), A (0.121), B (0.05), and AB (0.03).

Conclusions:

• Introducing ABO-compatible LDLT can alleviate pressure on liver transplant waiting lists, potentially reducing waitlist size by at least 16.5% over 20 years.
• This approach is estimated to save approximately 3600 lives within the same 20-year period.
• LDLT offers a viable strategy to improve organ availability and patient survival in liver transplantation.