Living donor liver paired exchange between pediatric and adult recipients due to donor graft size mismatch

Yong K Kwon; Navpreet Kaur; Kambiz Etesami; Shannon Zielsdorf; Brian Kim; Jeffrey Kahn; George Yanni; Ana Padilla; Hyosun Han; Yuri Genyk

doi:10.1016/j.ajt.2022.10.008

Living donor liver paired exchange between pediatric and adult recipients due to donor graft size mismatch

Am J Transplant. 2023 Mar;23(3):440-442. doi: 10.1016/j.ajt.2022.10.008. Epub 2023 Jan 12.

Authors

Affiliations

¹ Division of Abdominal Organ Transplantation and Hepato-Biliary and Pancreatic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Division of Abdominal Organ Transplantation, Children's Hospital Los Angeles, Los Angeles, California, USA.
² Division of Abdominal Organ Transplantation and Hepato-Biliary and Pancreatic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
³ Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
⁴ Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, California, USA.
⁵ Transplant Institute, Keck Medical Center of USC, Los Angeles, California, USA.
⁶ Division of Abdominal Organ Transplantation and Hepato-Biliary and Pancreatic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Division of Abdominal Organ Transplantation, Children's Hospital Los Angeles, Los Angeles, California, USA. Electronic address: yuri.genyk@med.usc.edu.

PMID: 36695680
DOI: 10.1016/j.ajt.2022.10.008

Abstract

Living donor liver transplantation is an effective means to decrease organ shortage. However, many potential living donors are currently being denied due to ABO incompatibility or inadequate donor liver volume. Liver paired exchange (LPE) provides a practical solution to overcome these obstacles, and yet the first case of LPE in the United States was only recently reported in 2020. Here, we report world's first case of LPE involving pediatric and adult recipients to avoid surgical complexity of the pediatric recipient and to increase the graft-to-recipient weight ratio of the adult recipient between 2 ABO compatible pairs. As living donor liver transplantation becomes more widely adopted, the need for pair exchange to improve surgical safety and postoperative outcomes between 2 ABO compatible pairs is likely to increase.

Keywords: clinical research/practice; liver transplantation/hepatology; liver transplantation: living donor; organ transplantation in general; paired exchange.

Publication types

Case Reports

MeSH terms

ABO Blood-Group System
Adult
Blood Group Incompatibility
Child
Humans
Kidney Transplantation*
Liver
Liver Transplantation*
Living Donors
United States

Substances

ABO Blood-Group System