Organ shortage is one of the biggest barriers in liver transplantation. Many patients have a willing family member ready to donate, but blood groups do not match — and historically, this meant the transplant could not happen. Fortunately, medical science has advanced, and today ABO-incompatible liver transplant (ABOi) offers a safe and effective solution.
For patients seeking timely treatment and for families struggling with organ mismatch, ABOi transplant has become life-saving. Many leading programs offering liver transplant in Delhi have now perfected this technique with excellent outcomes.
This blog explains ABOi transplant in simple, patient-friendly language.
What Is ABO-Incompatible Liver Transplant?
Normally, donor and recipient blood groups must match. But in an ABO-incompatible transplant, the donor’s blood group is different from the recipient’s.
Example:
- Donor: Blood group A
- Recipient: Blood group B
With special preparation, the transplant can still be done safely.
Why Is ABOi Transplant Needed?
Situations where ABOi becomes essential:
- No compatible donor in family
- Patient is too sick to wait
- Time-sensitive conditions like acute liver failure
- Pediatric cases where parents’ blood group does not match the child
Instead of waiting months (or dying while waiting), patients can receive a transplant on time.
How Does the Body Accept an Incompatible Liver?
The main challenge is antibodies.
If the recipient has antibodies against the donor’s blood group, the immune system
attacks the new liver.
To prevent this:
Doctors use:
- Antibody-removal procedures (plasmapheresis)
- Special immunosuppressive medicines (rituximab)
- Close monitoring before and after surgery
This preparation ensures the liver is not attacked by the recipient’s immune system.
Steps in ABO-Incompatible Transplant
1. Pre-Transplant Evaluation
Both donor and recipient undergo full testing:
- Liver function
- Kidney function
- Heart evaluation
- CT scan for liver volume
- Antibody titre measurement
If the titres are high, multiple sessions of plasmapheresis are done.
2. Immunosuppression Protocol
Patients receive specialized medicines to:
- Reduce antibody formation
- Prevent rejection
- Strengthen tolerance
These medicines are adjusted regularly.
3. The Surgery
The actual surgical steps are the same as standard transplant.
Experienced surgeons perform:
- Donor hepatectomy
- Recipient hepatectomy
- Graft implantation
- Vascular and biliary reconstruction
Centers offering liver transplant in Delhi have excellent success rates with ABOi cases when protocol is strictly followed.
4. Post-Transplant Care
Patients are monitored for:
- Rejection
- Infection
- Antibody-mediated reactions
Through regular blood tests and scans, doctors ensure the new liver functions smoothly.
How Safe Is ABO-Incompatible Transplant?
Earlier, ABOi transplants were considered high risk. Today, with modern protocols, outcomes are comparable to blood-group compatible transplants.
✓ Success rates globally: 90%+
✓ Pediatric success rates: Even higher
Benefits of ABO-Incompatible Transplant
- No need to wait for matching blood group
- Life-saving for urgent cases
- Allows more family members to donate
- Reduces waiting list deaths
- Excellent long-term results
Who Is the Best Candidate for ABOi?
- Children with biliary atresia
- Adults with acute liver failure
- Patients without same-blood-group donors
- High-risk patients who cannot afford to wait
Life After ABO-Incompatible Transplant
Recovery is similar to standard transplant.
Patients must:
- Take medicines on time
- Avoid alcohol and smoking
- Follow infection precautions
- Eat clean, cooked food
- Attend regular follow-ups
With proper care, patients enjoy a completely normal life.
Conclusion
ABO-incompatible liver transplant has changed the future for thousands of patients who once had no donor options. With highly experienced transplant teams and advanced protocols, centers offering liver transplant in Delhi are performing ABOi surgeries with outstanding results.
If you or your child has no blood-group–matched donor, ABOi may be the best — and only — life-saving option.
📞 For expert guidance and evaluation:
Consult Dr. Saurabh Singhal
Director & Head – Centre for Liver-GI Diseases & Transplantation
Aakash Healthcare, Dwarka, New Delhi
