ABO-incompatible Living Donor Liver Transplantation With Rituximab and Total Plasma Exchange Does Not Increase Hepatocellular Carcinoma Recurrence. Issue 10 (October 2018)

• Record Type: Journal Article
• Authors: Kim, Jong Man; Kwon, Choon Hyuck David; Joh, Jae-Won; Han, Sangbin; Yoo, Jeejin; Kim, Kyunga; Sinn, Dong Hyun; Choi, Gyu-Seong; Gerber, David A.; Egawa, Hiroto; Lee, Suk-Koo
• Is Part Of: Transplantation. Volume 102:Issue 10(2018)
• Publication Date: 2018-10
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000002154
• Languages: English
• ISSNs: 0041-1337

Abstract

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. Abstract : Retrospective review of data from a single center regarding ABO incompatible transplants for HCC indicates that a protocol using plasmapheresis and Rituximab does not increase recurrence.