Photo Credit: Aleksei Naumov

ABO-incompatible living donor liver transplantation (LDLT) represents a safe and effective strategy for increasing the donor pool in the absence of ABO-compatible liver donors, according to results published in Liver Transplantation. Researchers compared outcomes of ABO-incompatible LDLT with HLA-matched (biologically related) and HLA-unmatched (biologically unrelated) donor-recipient pairs in 90 cases of ABO-I liver transplants (HLA matched, n=35; HLA unmatched, n=55). Results showed that the peak bilirubin level in HLA-unmatched recipients were higher, while platelet count was lower than HLA-matched recipients (7.3 mg/dL vs 8.9 mg/dL). No significant difference in days-to-normal bilirubin, hospital length of stay, and discharge day from transplant were seen between groups. Post-operatively, HLA-unmatched recipients needed more pulse-steroid therapy than HLA-matched (38.2% vs 31.4%). Biliary complications and interventions were higher in the HLA-unmatched group (21.8%) than the HLA-matched group (11.4%). Renal complications requiring post-operative hemodialysis were greater in the HLA-unmatched group (16.4% vs 8.6%). Vascular complications were similar between groups.