{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T20:40:13Z","timestamp":1756068013259,"version":"3.44.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Intrahepatic cholangiopathy is a life-threatening sequela of ABO-incompatible liver transplantation. We analyzed the clinical impact of pretransplant administration of mycophenolate mofetil in reducing intrahepatic cholangiopathy in ABO-incompatible liver transplantation. Patients who underwent living donor liver transplantation between 2010 and April 2022 were included. Pretransplant mycophenolate mofetil was started in November 2020. A comparison between patients who experienced intrahepatic cholangiopathy and who did not among ABO-incompatible transplantation was performed. Recipients of ABO-incompatible transplantations were categorized based on donor surgery into open, laparoscopy without pretransplant mycophenolate mofetil, and laparoscopy with pretransplant mycophenolate mofetil groups. Cox analysis of intrahepatic cholangiopathy was performed. A total of 234 ABO-incompatible transplantations were included. Intrahepatic cholangiopathy occurred in 1.1% (n=1\/94), 13.3% (n=12\/90), and 2.0% (n=1\/50) of patients who received an ABO-incompatible liver with open surgery, laparoscopic donor surgery without pretransplant mycophenolate mofetil and laparoscopic donor surgery with pretransplant mycophenolate mofetil. (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.001) Multivariable analysis showed that transplantations involving a donor who underwent a laparoscopic hepatectomy and a recipient who did not receive pretransplant mycophenolate mofetil were associated with a higher risk of intrahepatic cholangiopathy (HR=13.449, CI=1.710\u2013105.800, <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.02) compared with transplantations from donors who underwent open surgery. Transplantations involving a donor who underwent laparoscopic donor surgery and a recipient who received pretransplant mycophenolate mofetil resulted in no increased risk compared with transplantations from donors who underwent open surgery. (HR=5.307, CI=0.315\u201389.366, <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.25) Laparoscopic donor hepatectomy was a risk factor for intrahepatic cholangiopathy in ABO-incompatible liver transplantation, while pretransplant mycophenolate mofetil was related to risk reduction of intrahepatic cholangiopathy.<\/jats:p>","DOI":"10.1097\/lvt.0000000000000070","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T06:05:14Z","timestamp":1674626714000},"page":"849-860","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Pretransplant mycophenolate mofetil may be associated with reduced intrahepatic cholangiopathy in ABO-incompatible liver transplantation"],"prefix":"10.1097","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9809-8525","authenticated-orcid":false,"given":"Jinsoo","family":"Rhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-0937","authenticated-orcid":false,"given":"Jong Man","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2545-3105","authenticated-orcid":false,"given":"Gyu-seong","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1732-6210","authenticated-orcid":false,"given":"Jae-Won","family":"Joh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"R1-20250824","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/TP.0000000000004250","article-title":"Current Status of ABO-incompatible Liver","volume":"107","author":"Egawa","year":"2022","journal-title":"Transplantation"},{"key":"R2-20250824","doi-asserted-by":"crossref","first-page":"e931963","DOI":"10.12659\/AOT.931963","article-title":"Can microscopic biliary reconstruction reduce biliary complication rate in abo-incompatible adult living donor liver transplantation?","volume":"26","author":"Lin","year":"2021","journal-title":"Ann Transplant"},{"key":"R3-20250824","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/01.TP.0000149337.40911.E4","article-title":"Successful use of anti-CD20 monoclonal antibody (rituximab) for ABO-incompatible living-related liver transplantation","volume":"79","author":"Usuda","year":"2005","journal-title":"Transplantation"},{"key":"R4-20250824","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/ajt.12520","article-title":"Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: a Japanese multicenter study","volume":"14","author":"Egawa","year":"2014","journal-title":"Am J Transplant"},{"key":"R5-20250824","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1002\/bjs.10048","article-title":"Case-matched comparison of ABO-incompatible 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Hepatol"},{"key":"R9-20250824","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/08941939.2016.1236158","article-title":"Changes in T Cells after ABO-incompatible liver transplantation","volume":"30","author":"Kim","year":"2017","journal-title":"J Invest Surg"},{"key":"R10-20250824","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1097\/TP.0000000000002154","article-title":"ABO-incompatible living donor liver transplantation with rituximab and total plasma exchange does not increase hepatocellular carcinoma recurrence","volume":"102","author":"Kim","year":"2018","journal-title":"Transplantation"},{"key":"R11-20250824","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1002\/lt.26429","article-title":"Complete transition from open surgery to laparoscopy: 8-year experience with more than 500 laparoscopic living donor hepatectomies","volume":"28","author":"Rhu","year":"2022","journal-title":"Liver Transpl"},{"key":"R12-20250824","doi-asserted-by":"crossref","first-page":"30","DOI":"10.21037\/atm-20-4703","article-title":"No diffuse intrahepatic biliary stricture after ABO-incompatible adult living donor liver transplantation using tailored rituximab-based desensitization protocol","volume":"9","author":"Natsuda","year":"2021","journal-title":"Ann Transl Med"},{"key":"R13-20250824","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3350\/cmh.2019.0023","article-title":"Immunologic strategies and outcomes in ABO-incompatible living donor liver transplantation","volume":"26","author":"Oh","year":"2020","journal-title":"Clin Mol Hepatol"}],"container-title":["Liver 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