{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:50:23Z","timestamp":1761630623546},"reference-count":52,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,7,26]],"date-time":"2012-07-26T00:00:00Z","timestamp":1343260800000},"content-version":"vor","delay-in-days":207,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The increasing demand for solid organ transplants has brought to light the need to utilize organs in critical situations despite ABO\u2010incompatibility. However, these transplantations are complicated by pre\u2010existing ABO antibodies which may be potentially dangerous and makes the transplantation prone to failure due to rejection with resulting necrosis or intrahepatic biliary complications. We report the clinical outcome of an emergency ABO\u2010incompatible liver transplant (due to fulminant hepatic failure with sudden and rapidly deteriorating mental status) using a modified therapeutic plasma exchange (TPE) protocol. The recipient was O\u2010positive with an initial anti\u2010B titer of 64 and the cadaveric organ was from a B\u2010positive donor. The patient underwent initial TPE during the peri\u2010operative period, followed by a series of postoperative daily TPE, and later a third series of TPE for presumptive antibody\u2010mediated rejection. The latter two were performed in conjunction with the use of IVIg and rituximab. The recipient's anti\u2010B titer was reduced and maintained at 8 or less 8 months post\u2010op. However, an elevation of transaminases 3 months post\u2010transplant triggered a biopsy which was consistent with cellular rejection and with weak C4d positive staining suggestive of antibody mediated rejection. Additional plasma exchange procedures were performed. The patient improved rapidly after modification of her immunosuppression regimen and treatment with plasma exchange. This case illustrates that prompt and aggressive plasma exchange, in conjunction with immunosuppression, is a viable approach to prevent and treat antibody mediated transplant rejection in emergency ABO\u2010incompatible liver transplant. J. Clin. Apheresis, 2012. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/jca.21244","type":"journal-article","created":{"date-parts":[[2012,7,26]],"date-time":"2012-07-26T06:57:54Z","timestamp":1343285874000},"page":"320-329","source":"Crossref","is-referenced-by-count":14,"title":["Emergency ABO\u2010incompatible liver transplant secondary to fulminant hepatic failure: Outcome, role of TPE and review of the literature"],"prefix":"10.1002","volume":"27","author":[{"given":"Robert W.","family":"Maitta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn","family":"Choate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukru H.","family":"Emre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Luczycki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"YanYun","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,7,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2006.00409.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2010.02339.x"},{"key":"e_1_2_6_4_2","first-page":"121","article-title":"Some aspects of adult living donor liver transplantation: small\u2010for\u2010size graft and ABO mismatch","volume":"8","author":"Takada Y","year":"2009","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20156"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181adcae6"},{"key":"e_1_2_6_7_2","first-page":"705","article-title":"The antibody crossmatch in liver transplantation","volume":"100","author":"Gordon RD","year":"1986","journal-title":"Surgery"},{"key":"e_1_2_6_8_2","first-page":"342","article-title":"Liver transplantation across ABO blood groups","volume":"100","author":"Gordon RD","year":"1986","journal-title":"Surgery"},{"key":"e_1_2_6_9_2","first-page":"1157","article-title":"Importance of ABO blood group matching in liver transplantation","volume":"27","author":"Busson M","year":"1995","journal-title":"Transplant Proc"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199409150-00003"},{"key":"e_1_2_6_11_2","first-page":"4575","article-title":"Experience with primary liver transplantation across ABO blood groups","volume":"19","author":"Gordon RD","year":"1987","journal-title":"Transplant Proc"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000044359.72379.E5"},{"key":"e_1_2_6_13_2","first-page":"59","article-title":"ABO\u2010incompatible orthotopic liver allografting in urgent indications","volume":"174","author":"Reding R","year":"1992","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20727"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3148.2001.00313.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0016521"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199504270-00009"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2007.00492.x"},{"key":"e_1_2_6_19_2","first-page":"467","article-title":"Compatible ABO mismatch and liver transplantation: a single center's experience","volume":"4","author":"Aladag M","year":"2006","journal-title":"Exp Clin Transplant"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.08.072"},{"key":"e_1_2_6_21_2","first-page":"489","article-title":"Antibody\u2010mediated rejection of human orthotopic liver allografts. A study of liver transplantation across ABO blood group barriers","volume":"132","author":"Demetris AJ","year":"1988","journal-title":"Am J Pathol"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)92082-S"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20652"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000137264.99113.2B"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21928"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2006.00447.x"},{"key":"e_1_2_6_27_2","first-page":"61","article-title":"Role of C3d and C4d complement fragments in the diagnostics of acute allograft rejection after transplantations","volume":"14","author":"Gierej B","year":"2009","journal-title":"Ann Transplant"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20002"},{"key":"e_1_2_6_29_2","first-page":"2567","article-title":"Expression of blood group antigen (A, B, H, Le(a), Le(b)) on liver allografts","volume":"24","author":"Hayashi S","year":"1992","journal-title":"Transplant Proc"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2005.00304.x"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)81196-1"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199504150-00011"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3089.2006.00286.x"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000110295.88926.5C"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000149337.40911.E4"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.10.122"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00470.x"},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2003.50011"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20240"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318231e9f8"},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318239e8e4"},{"key":"e_1_2_6_42_2","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/759581"},{"key":"e_1_2_6_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199201000-00022"},{"key":"e_1_2_6_44_2","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2000.6448"},{"key":"e_1_2_6_45_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000082723.02477.87"},{"issue":"2","key":"e_1_2_6_46_2","first-page":"S75","article-title":"Results of liver transplantation in fulminant hepatic failure","volume":"22","author":"Minz M","year":"2003","journal-title":"Indian J Gastroenterol"},{"key":"e_1_2_6_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.22160"},{"key":"e_1_2_6_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(98)01711-4"},{"key":"e_1_2_6_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20760"},{"key":"e_1_2_6_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21092"},{"key":"e_1_2_6_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2009.00792.x"},{"key":"e_1_2_6_52_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318173a70e"},{"key":"e_1_2_6_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21723"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.21244","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.21244","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T05:12:28Z","timestamp":1700543548000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.21244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1]]},"references-count":52,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2012,1]]}},"alternative-id":["10.1002\/jca.21244"],"URL":"https:\/\/doi.org\/10.1002\/jca.21244","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1]]}}}