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Updated: Sep 4, 2025
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Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
Published on: November 7, 2020
7.9K
Current Status of ABO-incompatible Liver Transplantation.
Hiroto Egawa1, Hideki Ohdan2, Kazuhide Saito3
1Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Transplantation
|July 18, 2022
Summary
Strategies for preventing antibody-mediated rejection after ABO-incompatible liver transplants are established using rituximab and other agents. Further research is needed to personalize immunosuppression and prevent complications like infection.
Area of Science:
- Hepatology
- Immunology
- Transplantation Medicine
Background:
- Living donor liver transplantation (LDLT) is prevalent in Asia due to donor scarcity.
- ABO-incompatible (ABO-I) LDLT requires specific protocols to prevent antibody-mediated rejection (AMR).
- Established desensitization protocols have improved safety and efficacy in ABO-I LDLT.
Purpose of the Study:
- To review current strategies for preventing AMR in ABO-I LDLT.
- To discuss the role of rituximab and immunosuppression in ABO-I LDLT.
- To identify future directions for optimizing patient outcomes and minimizing complications.
Main Methods:
- Review of established desensitization protocols for ABO-I LDLT.
- Analysis of rituximab's safety and efficacy, including its impact on cancer recurrence.
- Exploration of genetic factors (SNPs) for personalized immunosuppression.
Main Results:
- A desensitization protocol with rituximab, plasma pheresis, tacrolimus, and mycophenolate mofetil is the current standard for ABO-I LDLT.
- Rituximab does not increase hepatocellular carcinoma recurrence risk.
- Genetic variations may guide immunosuppression adjustments to reduce infection risk.
Conclusions:
- Current protocols provide a safe and effective approach to ABO-I LDLT.
- Personalized immunosuppression strategies are needed to balance AMR prevention and infection risk.
- Further research into immunological accommodation mechanisms is warranted.
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