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Preoperative Selective Desensitization of Live Donor Liver Transplant Recipients Considering the Degree of T Lymphocyte Cross-Match Titer, Model for End-Stage Liver Disease Score, and Graft Liver Volume
- Title
- Preoperative Selective Desensitization of Live Donor Liver Transplant Recipients Considering the Degree of T Lymphocyte Cross-Match Titer, Model for End-Stage Liver Disease Score, and Graft Liver Volume
- Authors
- Hong, Geun; Yi, Nam-Joon; Suh, Suk-won; Yoo, Tae; Kim, Hyeyoung; Park, Min-Su; Choi, YoungRok; Lee, Kyungbun; Lee, Kwang-Woong; Park, Myoung Hee; Suh, Kyung-Suk
- Ewha Authors
- 홍근
- SCOPUS Author ID
- 홍근
- Issue Date
- 2014
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- ISSN
- 1011-8934
1598-6357
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE vol. 29, no. 5, pp. 640 - 647
- Keywords
- Blood Grouping and Crossmatching; Desensitization; Graft Rejection; Living Donors; Liver Transplantation
- Publisher
- KOREAN ACAD MEDICAL SCIENCES
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- Several studies have suggested that a positive lymphocyte cross-matching (XM) is associated with low graft survival rates and a high prevalence of acute rejection after adult living donor liver transplantations (ALDLTs) using a small-for-size graft. However, there is still no consensus on preoperative desensitization. We adopted the desensitization protocol from ABO-incompatible LDLT. We performed desensitization for the selected patients according to the degree of T lymphocyte cross-match titer, model for end-stage liver disease (MELD) score, and graft liver volume. We retrospectively evaluated 230 consecutive ALDLT recipients for 5 yr. Eleven recipients (4.8%) showed a positive XM. Among them, five patients with the high titer (> 1: 16) by antihuman globulin-augmented method (T-AHG) and one with a low titer but a high MELD score of 36 were selected for desensitization: rituximab injection and plasmapheresis before the transplantation. There were no major side effects of desensitization. Four of the patients showed successful depletion of the T-AHG titer. There was no mortality and hyperacute rejection in lymphocyte XM-positive patients, showing no significant difference in survival outcome between two groups (P= 1.000). In conclusion, this desensitization protocol for the selected recipients considering the degree of T lymphocyte cross-match titer, MELD score, and graft liver volume is feasible and safe.
- DOI
- 10.3346/jkms.2014.29.5.640
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
- Files in This Item:
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0063JKMS_jkms-29-640.pdf(1.4 MB)
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