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Experience with primary liver transplantation across ABO blood groups.

THE LIVER has long been regarded as a privileged organ which can be transplanted across incompatible ABO blood groups with little risk of hyperacute rejection.1 However, in a recent review of 671 first, second, and third liver transplants we found a significant advantage for ABO donor-recipient identity for primary liver transplants.2 Although a large number of ABO mismatched grafts were successful, graft survival for primary liver grafts between ABO identical donor-recipient pairs was significantly better than grafts between ABO compatible but nonidentical or ABO incompatible donor-recipient pairs. 
 
The extent to which urgency of transplantation influenced these results was not fully assessed. An urgent factor existed in many of the transplants between ABO mismatched donor-recipient pairs. We here report a review of 745 primary liver transplants performed between Jan 1, 1981 and Dec 31, 1986 at the University Health Center of Pittsburgh in which the early outcome of primary liver transplantation across ABO blood groups was assessed in relationship to the urgency of transplantation.