Backgrounds: Emergency pediatric living donor liver transplantation (LDLT) is vital for acute liver failure patients facing life-threatening scenarios. However, we do not know the outcomes of emergent pediatric ABO-incompatible (ABOi) LDLT as an alternative treatment in patients without compatible living liver donors. The purpose of our study is to compare the outcomes between emergent pediatric ABOi-LDLT and emergent pediatric ABO-compatible (ABOc) LDLT using Korean Network for Organ Sharing (KONOS) data.
Methods: We conducted a retrospective KONOS data involving consecutive pediatric e-LDLT patients between 2017 and 2021 in Korea.
Results: The incidence of ABOc-LDLT and ABOi-LDLT was 83% (n=44) and 17% (n=9), respectively. The baseline, pre-transplant care, postoperative complications, and infectious complications of ABOi-LDLT were not different from those of ABOc-LDLT. The graft survival and overall survival at 5 years in ABOi-LDLT were 100% and 100%, respectively. The graft survival and overall survival in the ABOi-LDLT were better than in the ABOc-LDLT, but the survival difference between the two groups did not reach significant level. None was related with patient mortality and graft failure in multivariate analysis.
Conclusions: The present study supported that emergent pediatric ABOi-LDLT was feasible and safe in acute liver failure patients and urgent cases.