Ann Liver Transplant.  2024 Nov;4(2):63-70. 10.52604/alt.24.0009.

Outcomes of emergency pediatric ABO-incompatible living donor liver transplantation in Korea

• An S
• Kim J
• Kim SJ
• Kim SY
• Park JB
• Hwang Y
• Jung DH

• KMID: 2561850
• DOI: http://doi.org/10.52604/alt.24.0009

Abstract

Background
Emergency pediatric living donor liver transplantation (LDLT) is vital for acute liver failure patients in life-threatening situations. However, we do not know the outcomes of emergency pediatric ABO-incompatible (ABOi)-LDLT, which is an alternative treatment for patients without ABO-compatible (ABOc) living liver donors. The purpose of our study is to compare the outcomes between emergency pediatric ABOi-LDLT and emergency pediatric ABOc-LDLT using data from the Korean Network for Organ Sharing (KONOS).
Methods
We analyzed retrospective KONOS data for consecutive pediatric emergency LDLT patients between 2017 and 2021 in Korea.
Results
The incidence of ABOc-LDLT and ABOi-LDLT was 83% (n=44) and 17% (n=9), respectively. The baseline, pre-transplant care, postoperative complications, and infectious complications of ABOi-LDLT did not differ from those of ABOc-LDLT. Graft survival and overall survival at 5 years in ABOi-LDLT were 100% and 100%, respectively, which was better than in ABOc-LDLT, but the survival difference between the two groups was not significant. No developed acute rejection in ABOi-LDLT patients. No factors in the multivariate analysis were related to patient mortality or graft failure. Neither graft failure nor death was associated with ABOi-LDLT.
Conclusion
This study concludes that emergency pediatric ABOi-LDLT is safe and feasible for use in ALF patients as well as other urgent instances.

Keyword

Living donors; Donor selection; Survival; Blood group incompatibility