Apheresis in Adult Living-donor Liver Transplantation with ABO-incompatible Grafts

Adult living donor liver transplantation (ALDLT) across the ABO blood group barrier is now an accepted therapeutic option when no deceased or living blood group compatible donor is available for transplant within the desired or necessary time frame. Several different multimodal strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host and no gold standard has emerged yet. But the basis of most treatment regimens is apheresis or immunoadsorption.Here we will introduce common concepts of treatment regimens for ABO-incompatible ALDLT, exemplify the application of these concepts in a case series, and finally discuss the implications in the light of new therapeutic options.