Korean J Transplant.  2022 Nov;36(Supple 1):S294. 10.4285/ATW2022.F-4333.

Successful ABO incompatible living donor liver transplantation in giant polycystic liver disease: a case report

• Lin YC
• Li WF
• Hung KC
• Lin TS
• Lin CC
• Wang CC

• KMID: 2535521
• DOI: http://doi.org/10.4285/ATW2022.F-4333

Abstract

A 49-year-old female patient was diagnosed of having a giant polycystic liver with severe abdominal distention and sarcopenia for over 10 years. Her polycystic liver disease (PLD) became severe and resulted in dyspnea, abdominal pain, abnormal liver functions, and repeated intraabdominal infection. No prior transcatheter arterial embolization, percutaneous cyst drainage, fen-estration, or hepatectomy was performed prior to the liver transplantation. Owing to no available ABO compatible donor, an ABO incompatible (ABOi) living donor liver transplantation (LDLT) was arranged. The patient underwent our desensitization protocol with rituximab administration, plasma exchange and mycophenolate mofetil introduction. The pretransplant hemagglutinin titer was 1:16. The ABOi LDLT was smoothly performed with the technique of total mobilization and reduction of the abdominal cavity. A rebound of the hemagglutinin up to 1:64 was noted on postoperative day 2 and a 5-day course of intravenous immunoglobulin was given based on our protocol. The patient recovered uneventfully without any surgical complications. The native liver was measured 13 kg in weight. This is by far the largest polycystic liver in LDLT in our institute to date. We demonstrated a feasible approach to such advanced PLD cases without complications, even in the ABOi setting.