Garcia-Roca R, Tzvetanov IG, Jeon H, Hetterman E, Oberholzer J, Benedetti E. Successful living donor intestinal transplantation in cross-match positive recipients: Initial experience. World J Gastrointest Surg 2016; 8(1): 101-105 [PMID: 26843919 DOI: 10.4240/wjgs.v8.i1.101]
Corresponding Author of This Article
Enrico Benedetti, Professor, Head of the Division of Transplantation, Department of Surgery, University of Illinois at Chicago Hospital and Heals Sciences Systems, 840 S Wood Street, Suite 402, Chicago, IL 60622, United States. enrico@uic.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2016; 8(1): 101-105 Published online Jan 27, 2016. doi: 10.4240/wjgs.v8.i1.101
Successful living donor intestinal transplantation in cross-match positive recipients: Initial experience
Raquel Garcia-Roca, Ivo G Tzvetanov, Hoonbae Jeon, Elisabeth Hetterman, Jose Oberholzer, Enrico Benedetti
Raquel Garcia-Roca, Ivo G Tzvetanov, Hoonbae Jeon, Jose Oberholzer, Enrico Benedetti, Division of Transplantation, Department of Surgery, University of Illinois at Chicago Hospital and Heals Sciences Systems, Chicago, IL 60622, United States
Elisabeth Hetterman, Department of Pharmacy practice (MC 886), College of Pharmacy, University of Illinois at Chicago Hospital and Heals Sciences Systems, Chicago, IL 60622, United States
Author contributions: Garcia-Roca R data collection and writing of the manuscript; Tzvetanov IG writing of the manuscript; Hetterman E data collection and analysis; Jeon H revisions and corrections of the manuscript; Oberholzer J revisions and corrections of the manuscript; Benedetti E data supervision, original idea, and creation of guidelines for the manuscript, revision and correction of the manuscript.
Institutional review board statement: The Institutional review board does not require a protocol for reporting cases reports. Retrospective review of data pertaining intestinal transplant recipients is covered under protocol 2008-0070.
Informed consent statement: Recipients and donor consented for the procedures. The institutional review board protocol 2008-0070 refers to retrospective and prospective data collection and consent waived according to the study protocol.
Conflict-of-interest statement: No conflict of interest is declared by any of the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Enrico Benedetti, Professor, Head of the Division of Transplantation, Department of Surgery, University of Illinois at Chicago Hospital and Heals Sciences Systems, 840 S Wood Street, Suite 402, Chicago, IL 60622, United States. enrico@uic.edu
Telephone: +1-312-9966771 Fax: +1-312-4133483
Received: May 23, 2015 Peer-review started: May 23, 2015 First decision: August 14, 2015 Revised: August 18, 2015 Accepted: September 10, 2015 Article in press: September 16, 2015 Published online: January 27, 2016 Processing time: 243 Days and 12.2 Hours
Abstract
Sensitized patients tend to have longer waiting times on the deceased donor list and are at increased risk of graft loss from acute or chronic rejection compared to non-sensitized candidates. Desensitization protocols are utilized to decrease the levels of alloantibodies and to convert an initial positive cross-match to prospective donors into a negative crossmatch. These procedures are mostly available in the setting of living donation. Due to the elective nature of the procedure, desensitization protocols can be extended until the desire result is obtained prior to transplantation. We present two cases of successful desensitization protocol applied to living donor intestinal transplant candidates that converted to negative cross-match to their donors. We present two cases of intestinal transplant candidates with a potential living donor to whom they are sensitized. Both cases underwent successful transplantation after desensitization protocol. No evidence of humoral rejection has occurred in either recipient. Living donor intestinal transplantation in sensitized recipients against the prospective donors provides the ability to implement a desensitization protocol to convert to negative cross-match.
Core tip: Intestinal transplant candidates are frequently sensitized and waiting longer on the list. Living donation of intestine has been successful and allows for time to immunologically prepare sensitized recipient prior to transplant to achieve higher degree of success.
