Increasing Living Donor Liver Transplantation Using Liver Paired Exchange.
J Am Coll Surg
; 234(2): 115-120, 2022 Feb 01.
Article
in English
| MEDLINE | ID: covidwho-1713820
ABSTRACT
BACKGROUND:
Living donor liver transplantation (LDLT) continues to be the primary modality of liver transplantation in Asia, but it accounts for about 5% of all liver transplantations in the US. ABO incompatibility is the primary reason motivated donors are declined. Although kidney paired exchanges are common, liver paired exchange (LPE) is still evolving in the US. STUDYDESIGN:
This is a retrospective review (between January 1, 2019, and July 31, 2021) of our initial experience with LPE.RESULTS:
A total of 10 LPEs (20 LDLTs) were performed during the study period. Seven LPEs were initiated by a nondirected O donor. The other 3 pair sets involved 1 ABO compatible and 1 ABO incompatible pair. Transplantations in a pair set were completed within a mean of 4.8 (range 1-14) days of each other. All 20 donors are doing well with no major complications at 12.7 (range 1-20) months. Seventeen of 20 recipients are alive and have good allograft function. One recipient died in the early postoperative period. Two late deaths of patients with functioning allografts were due to COVID-19 (at 8 months) and peritoneal carcinomatosis and gram-negative sepsis (at 9 months).CONCLUSIONS:
LPE is feasible in a high-volume LDLT center and is a useful option to increase LDLT by overcoming ABO incompatibility. Nondirected donors can be utilized to initiate an LPE.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Tissue and Organ Procurement
/
Liver Transplantation
/
Living Donors
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Language:
English
Journal:
J Am Coll Surg
Journal subject:
Gynecology
/
Obstetrics
Year:
2022
Document Type:
Article
Affiliation country:
Xcs.0000000000000036
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