Evidence map›Paper›PMID 40728541›Full record

ArticleClinical journal of gastroenterology2025

Antibody-mediated rejection without elevated anti-blood type antibody after ABO-incompatible living donor liver transplantation: a case report.

Junichi Ogawa, Shinichi Nakanuma, Ryosuke Gabata, Mitsuyoshi Okazaki, Akihiro Seki, Satoshi Takada, Isamu Makino, Hiroko Ikeda, Takumi Taniguchi, Shintaro Yagi

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In one paragraph

Article in Clinical journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Junichi OgawaDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Shinichi NakanumaDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan. n_shin@gj8.so-net.ne.jp.
Ryosuke GabataDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Mitsuyoshi OkazakiDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Akihiro SekiDepartment of Gastroenterology, Graduate School of Medicine, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Satoshi TakadaDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Isamu MakinoDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Hiroko IkedaDepartment of Pathology, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Takumi TaniguchiIntensive Care Unit, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Shintaro YagiDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The incidence of antibody-mediated rejection (AMR) following ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) has decreased since the introduction of rituximab. However, the prognosis is extremely poor once AMR develops. Therefore, perioperative monitoring of anti-blood type antibody titers is important. Here, we report a rare case of ABO-I LDLT that developed AMR without elevated anti-blood type antibody titers. The patient was a 65-year-old man (Type A +) who underwent ABO-I LDLT for alcoholic cirrhosis using a liver right-lobe graft from a 60-year-old woman (Type B +). Rituximab was administered preoperatively. On postoperative day (POD) 5, the portal blood flow decreased drastically. Liver biopsy showed AMR, although there was no increase in the anti-blood type B antibody titer. This resulted in a delay in the diagnosis and treatment of AMR. Steroid pulse therapy, high-dose intravenous immunoglobulin, and plasma exchange were immediately performed. However, the patient developed prolonged graft dysfunction and died on POD40. The pathological findings at autopsy revealed a diagnosis of hepatic veno-occlusive disease. This case suggests that a method other than anti-blood type antibodies should be developed for early diagnosis of AMR.

Indexed as

ABO Blood-Group SystemBlood Group IncompatibilityGraft RejectionLiver TransplantationAgedFatal OutcomeFemaleHumansLiver Cirrhosis, AlcoholicLiving DonorsMaleMiddle AgedRituximabABO Blood-Group SystemRituximabABO-incompatibleAnti-blood-type antibodyAntibody-mediated rejectionLiver transplantationLiving donor

Identifiers

PMID40728541

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