Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation

Minoru Tanabe, Motohide Shimazu, Go Wakabayashi, Ken Hoshino, Shigeyuki Kawachi, Tomohisa Kadomura, Hiroaki Seki, Yasuhide Morikawa, Masaki Kitajima

Research output: Contribution to journalArticle

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Abstract

Background. ABO-incompatible liver transplantation is associated with an extremely complicated postoperative course, especially when the recipients are adults. Methods. Two adult patients underwent living-donor liver transplantation from ABO-incompatible donors. The antirejection therapy included multiple perioperative plasmapheresis, splenectomy, systemic triple immunosuppressive regimen with tacrolimus, methylprednisolone, and cyclophophamide, or azathioprine. In addition to these conventional approaches, we performed intraportal infusion therapy after transplantation with methylprednisolone, prostaglandin E1, and gabexate mesilate. Results. With our protocol, antidonor blood group antibody titers in both cases remained low without any evidence of rejection or vascular complications throughout the postoperative course. Biliary complications were transient and resolved completely. The patients have now survived 30 and 12 months posttransplantation and have regained normal life activity with good liver function. Conclusions. Our experience has shown the feasibility of controlling rejection and other complications in adult ABO-incompatible liver transplantation under intraportal infusion therapy.

Original languageEnglish
Pages (from-to)1959-1961
Number of pages3
JournalTransplantation
Volume73
Issue number12
Publication statusPublished - 2002 Jun 27

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Liver Transplantation
Methylprednisolone
Gabexate
Plasmapheresis
Alprostadil
Living Donors
Azathioprine
Tacrolimus
Splenectomy
Immunosuppressive Agents
Blood Group Antigens
Immunosuppression
Blood Vessels
Therapeutics
Transplantation
Tissue Donors
Antibodies
Liver

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Tanabe, M., Shimazu, M., Wakabayashi, G., Hoshino, K., Kawachi, S., Kadomura, T., ... Kitajima, M. (2002). Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. Transplantation, 73(12), 1959-1961.

Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. / Tanabe, Minoru; Shimazu, Motohide; Wakabayashi, Go; Hoshino, Ken; Kawachi, Shigeyuki; Kadomura, Tomohisa; Seki, Hiroaki; Morikawa, Yasuhide; Kitajima, Masaki.

In: Transplantation, Vol. 73, No. 12, 27.06.2002, p. 1959-1961.

Research output: Contribution to journalArticle

Tanabe, M, Shimazu, M, Wakabayashi, G, Hoshino, K, Kawachi, S, Kadomura, T, Seki, H, Morikawa, Y & Kitajima, M 2002, 'Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation', Transplantation, vol. 73, no. 12, pp. 1959-1961.
Tanabe M, Shimazu M, Wakabayashi G, Hoshino K, Kawachi S, Kadomura T et al. Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. Transplantation. 2002 Jun 27;73(12):1959-1961.
Tanabe, Minoru ; Shimazu, Motohide ; Wakabayashi, Go ; Hoshino, Ken ; Kawachi, Shigeyuki ; Kadomura, Tomohisa ; Seki, Hiroaki ; Morikawa, Yasuhide ; Kitajima, Masaki. / Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. In: Transplantation. 2002 ; Vol. 73, No. 12. pp. 1959-1961.
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AB - Background. ABO-incompatible liver transplantation is associated with an extremely complicated postoperative course, especially when the recipients are adults. Methods. Two adult patients underwent living-donor liver transplantation from ABO-incompatible donors. The antirejection therapy included multiple perioperative plasmapheresis, splenectomy, systemic triple immunosuppressive regimen with tacrolimus, methylprednisolone, and cyclophophamide, or azathioprine. In addition to these conventional approaches, we performed intraportal infusion therapy after transplantation with methylprednisolone, prostaglandin E1, and gabexate mesilate. Results. With our protocol, antidonor blood group antibody titers in both cases remained low without any evidence of rejection or vascular complications throughout the postoperative course. Biliary complications were transient and resolved completely. The patients have now survived 30 and 12 months posttransplantation and have regained normal life activity with good liver function. Conclusions. Our experience has shown the feasibility of controlling rejection and other complications in adult ABO-incompatible liver transplantation under intraportal infusion therapy.

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