ArticleInternational journal of surgery (London, England)2025
Comparable long-term survival and biliary outcomes in ABO-incompatible and compatible living donor liver transplantation.
Article in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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4 authors.
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Abstract
backgroundABO-incompatible (ABO-I) living donor liver transplantation (LDLT) has demonstrated acceptable short-term outcomes with rituximab-based desensitization. However, data on long-term outcomes remain limited. This study aimed to evaluate the long-term impact of ABO incompatibility on LDLT outcomes, particularly patient survival and biliary complications.
methodsA retrospective review was conducted of patients undergoing LDLT at a single center between January 2012 and December 2022. Patients were categorized into ABO-I and ABO-compatible (ABO-C) groups. Long-term outcomes, including overall survival and biliary complications, were compared.
resultsA total of 511 patients underwent LDLT, comprising 121 ABO-I and 390 ABO-C recipients. Recipient baseline characteristics were comparable between groups, while donor age, sex, and biological relationship differed significantly. The median follow-up duration was 90.1 months. The 3-, 5-, and 10-year overall survival rates were 73.9%, 65.3%, and 61.4% in the ABO-I group, and 77.5%, 73.7%, and 69.6% in the ABO-C group (p = 0.1147). Cumulative biliary complication rates at 3, 5, and 10 years were 48.3%, 51.9%, and 53.4% in the ABO-I group, compared to 46.0%, 49.2%, and 50.9% in the ABO-C group (p = 0.9243). Risk factor analysis identified prolonged operative time as a predictor of biliary complications in ABO-I recipients and prolonged hospital stay in ABO-C recipients.
conclusionsABO-I LDLT provides comparable long-term outcomes to ABO-C LDLT in terms of overall survival and biliary complications under current desensitization and immunosuppressive protocols. ABO-I LDLT is a safe and effective option when ABO-compatible donors are unavailable.
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