Liver transplantation is the only effective treatment for the patients with acute or chronic liver failure. However, due to shortage of matched donors, many patients are unable to undergo the procedure. With the advancements in medical field, ABO incompatible liver transplant is now possible, which permits use of available organ regardless of ABO blood type.
PROCEDURE
The immunosuppressive protocol is to be followed, that consists of rituximab and plasmapheresis, prior to Liver Transplant. Plasmapheresis is planned for up to 2 weeks after transplant aiming at maintaining low levels of anti-ABO titers.
DURATION
The liver transplant is carried out as for compatible transplant, once the desensitization protocol is complete. The operation may take six to eight hours. Total hospital stay may be of three weeks.
RECOVERY
After the hospital stay, it may take another 6 - 12 months to return to normal routine. Close monitoring to watch the antibody levels is needed. Regular check-ups, with blood tests and x-rays, etc would be needed for many years.
RISKS
Two major complications following liver transplantation are rejection and infection. The body’s immune system may react against the transplanted organ considering it to be a foreign substance. Anti-rejection medications are given to ward off the immune attack. This suppresses the immune system, thus increasing chances of infection and cancer.
The medicines may also cause high blood pressure and high cholesterol, and increase the risks for diabetes. Besides, there remains a risk of bleeding, stroke, drug reaction, etc.