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Case Reports
. 2023 Dec 31;37(4):306-309.
doi: 10.4285/kjt.23.0070.

Accidental ABO-incompatible pediatric liver transplantation with blood group antigen immune and operational tolerance: a case report with 21 years of follow-up

Hyo-Sin Kim  1 , Soo Jin Na Choi  1 , Ho Kyun Lee  1 , Sola Lee  1
Affiliations
Case Reports

Accidental ABO-incompatible pediatric liver transplantation with blood group antigen immune and operational tolerance: a case report with 21 years of follow-up

Hyo-Sin Kim et al. Korean J Transplant. .

Abstract

Liver transplantation is a critical procedure for patients with end-stage liver disease, but it is often hindered by ABO-incompatibility between the donor and recipient, which can lead to immediate humoral rejection. We present a unique case involving a 10-month-old patient who, by accident, received an ABO-incompatible partial liver transplant from a type A mother without undergoing desensitization. Remarkably, during a 21-year follow-up period, the patient exhibited no signs of humoral or graft rejection, despite nonadherence to medication. This case highlights the possibility of dual tolerance in pediatric ABO-incompatible liver transplantation and provides insights into immune tolerance mechanisms, with implications for enhancing patient care and reducing healthcare costs. Further research is necessary to clarify these mechanisms and to evaluate the long-term durability of tolerance in pediatric transplant recipients.

Keywords: ABO blood-group system; Case report; Immune tolerance; Liver transplantation.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Computed tomography images at 21 years after transplantation. (A) Coronal view: patent hepatic artery and portal vein flow with splenomegaly and perisplenic varices. (B) Axial view: patent portal flow and hepatic vein flow without bile duct dilatation.
See this image and copyright information in PMC

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