Liver transplantation

Evading antigens—ABO-incompatible liver transplantation

Whereas the status of the liver as privileged and exempt from humoral rejection has fallen, attempts at breaching the blood group barrier during transplantation have continued. Previously restricted to paediatric patients and emergencies, advances in immunosuppression protocols have improved outcomes to the point that ABO-incompatible liver transplantation might be more widely used in adults.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1

    Song, G. W. et al. ABO-incompatible adult living donor liver transplantation under the desensitization protocol with rituximab. Am. J. Transplant.

  2. 2

    Starzl, T. E. et al. Fifteen years of clinical liver transplantation. Gastroenterology 77, 375–388 (1979).

    CAS  Article  Google Scholar 

  3. 3

    Gordon, R. D. et al. Liver transplantation across ABO blood groups. Surgery 100, 342–348 (1986).

    CAS  PubMed  Google Scholar 

  4. 4

    Gugenheim, J., Samuel, D., Reynes, M. & Bismuth, H. Liver transplantation across ABO blood group barriers. Lancet 336, 519–523 (1990).

    CAS  Article  Google Scholar 

  5. 5

    Tokunaga, Y. et al. Living related liver transplantation across ABO blood groups with FK506 and OKT3. Transpl. Int. 6, 313–318 (1993).

    CAS  Article  Google Scholar 

  6. 6

    Nakamura, Y. et al. Successful case of adult ABO-incompatible liver transplantation: beneficial effects of intrahepatic artery infusion therapy: a case report. Transplant. Proc. 36, 2269–2273 (2004).

    CAS  Article  Google Scholar 

  7. 7

    Tanabe, M. et al. Intraportal infusion therapy as a novel approach to adult ABO-incompatible liver transplantation. Transplantation 73, 1959–1961 (2002).

    Article  Google Scholar 

  8. 8

    Monteiro, I., McLoughlin, L. M., Fisher, A., de la Torre, A. N. & Koneru, B. Rituximab with plasmapheresis and splenectomy in abo-incompatible liver transplantation. Transplantation 76, 1648–1649 (2003).

    Article  Google Scholar 

  9. 9

    Kawagishi, N. et al. New strategy for ABO-incompatible living donor liver transplantation with anti-CD20 antibody (rituximab) and plasma exchange. Transplant. Proc. 37, 1205–1206 (2005).

    CAS  Article  Google Scholar 

  10. 10

    Egawa, H. et al. Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: a Japanese multicenter study. Am. J. Transplant. 14, 102–114 (2014).

    CAS  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Ronald W. Busuttil.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zarrinpar, A., Busuttil, R. Evading antigens—ABO-incompatible liver transplantation. Nat Rev Gastroenterol Hepatol 12, 676–678 (2015).

Download citation