Avolio A W, Barone M
Department of Surgery, Transplantation Service, Catholic University A. Gemelli, Rome, Italy.
Transplant Proc. 2006 May;38(4):1063-5. doi: 10.1016/j.transproceed.2006.03.007.
Candidates for liver transplantation with AB blood group remain on the waiting list for shorter times than candidates with O blood group. To investigate the reasons of this phenomenon, we analyzed data concerning deceased donors, liver transplant candidates, and liver first transplants performed in the United States during the period 2003 to 2004. The percentage of deceased donors with blood group O was higher than that of candidates on the waiting list with the identical blood group (P < .05). On the other hand, for blood groups A, B, and AB an opposite situation was observed: the percentages of deceased donors were significantly lower compared to those candidates with the identical blood group (A blood group, P < .05; B and AB blood groups, P < .001). When the number of grafts from deceased donors was compared with the number of those effectively transplanted, a negative difference for O blood group recipients was found (ie, transplanted livers < harvested livers) and a positive one for AB blood group (transplanted livers > harvested livers) were found. Since disease progression and causes of acute liver failure, including primary nonfunction and hepatic artery thrombosis leading to retransplantation were similar among the various blood groups, we concluded that the shorter waiting time for AB patients in the pre-MELD era was due to the use of compatible livers to the detriment of group O recipients.
AB血型的肝移植候选者在等待名单上的时间比O血型的候选者短。为了探究这一现象的原因，我们分析了2003年至2004年期间在美国进行的关于已故供体、肝移植候选者和首次肝移植的数据。O血型已故供体的百分比高于等待名单上相同血型的候选者（P <.05）。另一方面，对于A、B和AB血型，观察到相反的情况：已故供体的百分比与相同血型的候选者相比显著较低（A血型，P <.05；B和AB血型，P <.001）。当将已故供体的移植物数量与有效移植的数量进行比较时，发现O血型受者存在负差异（即移植的肝脏<获取的肝脏），而AB血型存在正差异（移植的肝脏>获取的肝脏）。由于不同血型之间疾病进展和急性肝衰竭的原因，包括导致再次移植的原发性无功能和肝动脉血栓形成相似，我们得出结论，在MELD时代之前，AB患者等待时间较短是由于使用了与O型受者不相容的肝脏。
