直近一年間の累計
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ID 111276
著者
Yasuda, Mitsuhiro Kyushu University
Ikegami, Toru Kyushu University
Imai, Daisuke Kyushu University
Wang, Huanlin Kyushu University
Bekki, Yuki Kyushu University
Itoh, Shinji Kyushu University
Yoshizumi, Tomoharu Kyushu University
Soejima, Yuji Kyushu University
Shirabe, Ken Kyushu University
Maehara, Yoshihiko Kyushu University
キーワード
living donor liver transplantation
blood type incompatible
acute liver failure
rituximab
high-flow continuous hemodiafiltration
資料タイプ
学術雑誌論文
抄録
Introduction. Living donor liver transplantation (LDLT) using ABO-incompatible (ABOi) graft for acute liver failure (ALF) is a developing treatment modality. Methods. We reviewed the changes in our treatment strategies in applying ABOi LDLT for FH over our fourteen years of experience. Results. Five patients with ALF received LDLT in adults using ABOi grafts, with different but gradually renewed protocols. The etiologies for acute liver failure included autoimmune hepatitis (n=3) and unknown (n=2). The desensitization protocol for ABOi barrier included Case #1 ; local infusion (portal vein)+plasma exchange (PE), Case #2 ; local infusion (hepatic artery)+rituximab+PE, Case #3 and #4 ; rituximab+PE, and Case #5 ; rituximab+PE under high-flow continuous hemodiafiltration. Local infusion was abandoned since Case #3, because Case #1 had portal vein thrombosis resulting in graft necrosis and Case #2 had hepatic artery dissection. The patients (Case #2 and #3), who received rituximab within 7 days before LDLT, experienced antibody-mediated rejection. Thus, the most recent protocol for ABOi-LDLT is that rituximab is given 2 weeks before LDLT, followed by high-flow continuous hemodiafiltration to obstacle hepatic encephalopathy until LDLT. The four patients except Case #1 are doing well with good graft function over 3.8±3.7 years. Conclusion. Rituximab-based ABOi-LDLT, most-recently under high-flow hemodiafiltration for treating encephalopathy, is a feasible option for applying LDLT for ALF.
掲載誌名
The Journal of Medical Investigation
ISSN
13496867
13431420
cat書誌ID
AA11166929
AA12022913
出版者
Faculty of Medicine Tokushima University
62
3-4
開始ページ
184
終了ページ
187
並び順
184
発行日
2015-08
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版