ArticleHepatobiliary surgery and nutrition2025
Intention-to-treat approach for survival benefit of ABO-incompatible living-donor liver transplantation in patients with high Model for End-stage Liver Disease scores.
Article in Hepatobiliary surgery and nutrition, 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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Abstract
Background: ABO-incompatible (ABOi) living-donor liver transplantation (LDLT) is increasingly considered for patients with end-stage liver disease or hepatocellular carcinoma, in regions facing severe organ shortage. However, its applicability for patients with high Model for End-stage Liver Disease (MELD) scores remains uncertain. We aimed to investigate the survival benefit of ABOi-LDLT in high MELD patients using intention-to-treat (ITT) analysis in retrospective cohort study. Methods: In a single-center study, 649 patients on a liver transplantation (LT) waitlist were divided into three groups: ITT-ABOi-LDLT (n=45), ITT-ABO-compatible (ABOc)-LDLT (n=162), and ITT-deceased-donor LT (DDLT) (n=442). Results: The ITT-ABOi-LDLT group had a median initial isoagglutinin-titer of 1:128 and 71.1% underwent ABOi-LDLT after desensitization. This group showed a higher survival rate compared to ITT-DDLT (66.7% Conclusions: ABOi-LDLT offers a viable option for high MELD score patients, improving survival compared to DDLT and yielding similar posttransplant outcomes to DDLT and ABOc-LDLT in severe organ shortage region.
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