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
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資料タイプ |
学術雑誌論文
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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.
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掲載誌名 |
The Journal of Medical Investigation
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ISSN | 13496867
13431420
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cat書誌ID | AA11166929
AA12022913
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出版者 | Faculty of Medicine Tokushima University
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巻 | 62
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号 | 3-4
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開始ページ | 184
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終了ページ | 187
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並び順 | 184
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発行日 | 2015-08
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出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
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著者版フラグ |
出版社版
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