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Transplantation. 2018 Oct;102(10):1695-1701. doi: 10.1097/TP.0000000000002154.

ABO-incompatible Living Donor Liver Transplantation With Rituximab and Total Plasma Exchange Does Not Increase Hepatocellular Carcinoma Recurrence.

Author information

1
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3
Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea.
4
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
5
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
6
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.

Abstract

BACKGROUND:

ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) has a high success rate. This study compares hepatocellular carcinoma (HCC) recurrence in ABO-I LDLT with that in ABO-compatible (ABO-C) LDLT and explores the effects of rituximab prophylaxis and total plasma exchange on HCC recurrence after LDLT.

METHODS:

Two hundred forty patients with a diagnosis of HCC underwent LDLT between 2010 and 2015. Fifty-nine patients underwent ABO-I LDLT.

RESULTS:

Baseline, perioperative, and tumor characteristics did not vary between the 2 groups. The 1-, 2-, and 3-year disease-free survival rates in the ABO-I LDLT and ABO-C LDLT groups were 90.3%, 79.7%, and 73.3% and 86.7%, 79.0%, and 75.3%, respectively (P = 0.96). The overall patient survival rates for the same period in the ABO-I LDLT and ABO-C LDLT groups were 90.6%, 85.0%, and 81.9% and 88.0%, 83.5%, and 82.5%, respectively (P = 0.77). Hepatocellular carcinoma recurrence after LDLT was associated with preoperative α-fetoprotein greater than 35 ng/mL, increased tumor size, encapsulation, and microvascular invasion. ABO incompatibility was not related to HCC recurrence after LDLT.

CONCLUSIONS:

Hepatocellular carcinoma recurrence and patient survival in the ABO-I LDLT group are comparable to those in the ABO-C LDLT group. Rituximab prophylaxis and total plasma exchange do not increase HCC recurrence after LT.

PMID:
29494419
DOI:
10.1097/TP.0000000000002154
[Indexed for MEDLINE]

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