Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. May 29, 2020; 10(5): 138-146
Published online May 29, 2020. doi: 10.5500/wjt.v10.i5.138
ABO-nonidentical liver transplantation from a deceased donor and clinical outcomes following antibody rebound: A case report
Milena Peruhova, Viktoriya Georgieva, Nonka Yurukova, Monika Sekulovska, Gabriela Panayotova, Antoaneta Mihova, Velislava Terzieva, Tsvetelina Veselinova Velikova
Milena Peruhova, Viktoriya Georgieva, Nonka Yurukova, Monika Sekulovska, Gabriela Panayotova, Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Antoaneta Mihova, Velislava Terzieva, Tsvetelina Veselinova Velikova, Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Author contributions: Peruhova M, Georgieva V, Yurukova N, Sekulovska M, and Panayotova G were the clinicians involved in patient diagnostics, management, therapy, and follow-up; Peruhova M reviewed the literature and wrote the draft; Georgieva V and Velikova TV contributed to reviewing the literature and manuscript drafting; Mihova A performed immunological testing; Terzieva V and Velikova TV analyzed and interpreted the laboratory and immunological findings; Velikova TV was responsible for the critical revision of the manuscript for relevant intellectual content; All of the authors approved the final version of the paper prior to submission.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Tsvetelina Veselinova Velikova, MD, PhD, Assistant Professor, Department of Clinical Immunology, University Hospital Lozenetz, Kozyak 1 Street, Sofia 1407, Bulgaria. tsvelikova@medfac.mu-sofia.bg
Received: February 28, 2020
Peer-review started: February 22, 2020
First decision: April 9, 2020
Revised: April 22, 2020
Accepted: May 5, 2020
Article in press: May 5, 2020
Published online: May 29, 2020
Processing time: 90 Days and 12.9 Hours
Core Tip

Core tip: Living and deceased donor liver transplantation (LT) may apply for both urgent and elective LT, especially for those patients on a long waiting list with rapidly deteriorating liver function. The main threat after ABO-nonidentical LT is the antibody-mediated rejection due to anti-A/B antibodies as a result of passenger lymphocyte syndrome. Our case demonstrated that a proper treatment protocol, including immunosuppression, anti-CD20 monoclonal antibodies, intravenous immunoglobulin, anti-infectious agents, etc, is potent to maintain and even lower the isotiters of antibodies after ABO-nonidentical LT. However, due to other complications, the outcome for the patient was unfavorable.