Experiences of 26 cases in liver transplantation across ABO blood group barrier

Objective To summarize the experiences of 26 case of liver transplantation across ABO barrier in our hospital,and on the basis of literature review,further discuss the feasibility of ABO-incompatible liver transplantation.Methods The clinical data of 395 caces of liver transplantation since January 2009 to December 2012 were retrospectively analyzed.Of them,26 cases were across ABO blood group,including 17 ABO-compatible (ABO-C) and 9 ABO-incompatible (ABO-I).The patients were grouped as ABO-identical(ABO-Id,n =369),ABO-compatible(ABO-C,n =17) and ABO-incompatible(ABO-I,n =9),patient survivals and the rates of biliary complications,vascular complications,infection,acute and chronic rejection were compared among 3 groups.Results the 1-year and 2-year patient's survival rates were 87.3％,82.4％,88.9％,and 78.3％,70.6％,66.7％ in ABO-Id,ABO-C,ABO-I group,respectively.The accumulative survival rates among 3 groups were not significantly different (log rank test,P ＞ 0.05).The incidence of general complications and biliary complications was higher in ABO-I than in ABO-Id(P =0.035,P =0.001).There were no significant differences among the 3 groups in vascular complications,infection,acute and chronic rejection (P ＞ 0.05).Conclusions Although the complication incidence is higher in ABO-incompatible liver transplantation,the patient survival rate is compatible to ABO-compatible liver transplantation.Thus,for patients who are waiting grafts for a long time or need emergent liver transplant,ABO-incompatible liver transplantation is safe and feasible. Key words: ABO-incompatible;  Liver transplantation;  Complication ;  Survival rate