Impact of Baseline Anti-ABO Antibody Titer on Biliary Complications in ABO-Incompatible Living-Donor Liver Transplantation.

Yu, Se-Hyeon; Jo, Hye-Sung; Yu, Young-Dong; Park, Pyoung-Jae; Han, Hyung-Joon; Kim, Sang-Jin; Kamarulzaman, Syahrul Hadi; Kim, Dong-Sik

Yu, Se-Hyeon; Jo, Hye-Sung; Yu, Young-Dong; Park, Pyoung-Jae; Han, Hyung-Joon; Kim, Sang-Jin; Kamarulzaman, Syahrul Hadi; Kim, Dong-Sik.

Afiliación

Yu SH; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Jo HS; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Yu YD; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Park PJ; Division of Transplantation and Vascular Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Han HJ; Division of Hepatobiliopancreas and Transplant Surgery, Korea University Ansan Hospital, Ansan-si 05505, Republic of Korea.
Kim SJ; Division of Hepatobiliopancreas and Transplant Surgery, Korea University Ansan Hospital, Ansan-si 05505, Republic of Korea.
Kamarulzaman SH; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Kim DS; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.

J Clin Med ; 13(16)2024 Aug 14.

Article en En | MEDLINE | ID: mdl-39200931

ABSTRACT

ABSTRACT

Background:

Although advancements in desensitization protocols have led to increased ABO-incompatible (ABOi) living-donor liver transplantation (LDLT), a higher biliary complication rate remains a problem. This study evaluated the effect of baseline anti-ABO antibody titers before desensitization on biliary complications after ABOi LDLT.

Methods:

The study cohort comprised 116 patients in the ABO-compatible group (ABOc), 29 in the ABOi with the low titer (<1128) group (ABOi-L), and 14 in the high titer (≥1128) group (ABOi-H).

Results:

Biliary complications occurred more frequently in the ABOi-H group than in the ABOi-L and ABOc groups (7 [50.0%] vs. 8 [27.6%] and 24 [20.7%], respectively, p = 0.041). Biliary complication-free survival was significantly worse in the ABOi-H group than in the other groups (p = 0.043). Diffuse intrahepatic biliary strictures occurred more frequently in the ABOi-H group than in the other groups (p = 0.005). Multivariable analysis revealed that the high anti-ABO antibody titer (≥1128) is an independent risk factor for biliary complications (hazard ratio 3.943 [1.635-9.506]; p = 0.002).

Conclusions:

A high baseline anti-ABO antibody titer (≥1128), female sex, and hepatic artery complications are significant risk factors for biliary complications.

Palabras clave

ABO-incompatible living donor liver transplantation; biliary complication

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article Pais de publicación: Suiza