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Updated: Sep 11, 2025

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

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Status 1A ABO Incompatible Liver Transplant With Eculizumab as a Rescue Treatment for a Patient With Primary

Katsunori Miyake¹, Luke G Atia¹, Maria Jimena Alaniz¹

¹Division of Transplantation, Department of Surgery, University of Illinois Chicago, Illinois.

Transplantation Proceedings

|August 17, 2025

Summary

Eculizumab offers a simplified desensitization strategy for ABO-incompatible liver transplants in hemodynamically unstable patients. This approach avoids plasmapheresis and immunoglobulin therapy, enabling successful re-transplantation.

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Last Updated: Sep 11, 2025

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

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Published on: May 7, 2015

Author Spotlight: Exploring Cold Ischemia and Warm Reperfusion Injury in Fatty Liver Transplantation

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Published on: December 1, 2023

Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation

Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation

Published on: November 7, 2020

Area of Science:

Transplantation immunology
Hepatology
Nephrology

Background:

Primary graft non-function (PNF) after liver transplant (LT) necessitates urgent re-transplantation.
ABO blood type incompatibility (ABOi) presents a significant immunological barrier to timely LT.
Hemodynamic instability complicates management in patients requiring re-transplantation.

Purpose of the Study:

To evaluate Eculizumab as a desensitization strategy for ABOi LT in a hemodynamically unstable patient.
To assess the efficacy of Eculizumab in preventing hyperacute rejection in ABOi LT.
To determine if Eculizumab can simplify management by avoiding traditional desensitization methods.

Main Methods:

Case report of a 68-year-old male with NASH cirrhosis undergoing re-LT.
Administration of a single dose of Eculizumab prior to reperfusion for ABOi LT.
Monitoring of ABO blood type antibody titers and clinical outcomes.

Main Results:

Successful ABOi LT with Eculizumab desensitization in a hemodynamically unstable patient.
Achieved ABO blood type antibody titer reduction without plasmapheresis or immunoglobulin therapy.
Patient discharged without rejection or complications, highlighting Eculizumab's effectiveness.

Conclusions:

Eculizumab serves as a viable alternative desensitization protocol for ABOi LT.
This strategy simplifies management for hemodynamically unstable Status 1A LT patients.
Eculizumab facilitates successful re-transplantation in challenging immunological scenarios.