[ABO血型不相容肝移植治疗肝衰竭]

[ABO-incompatible liver transplantation for liver failure].

作者信息

Yang Yang, Xu Chi, Chen Ying-hua, Lu Min-qiang, Cai Chang-jie, Li Hua, Wang Gen-shu, Yi Shu-hong, Zhang Jian, Yi Hui-min, Zhang Jun-feng, Jiang Nan, Zhao Hui, Li Xi, Li Min-ru, Chen Gui-hua

机构信息

Liver Transplant Center, Third Affiliated Hospital of Sun Yat-sen University, Transplantation Research Institute of Sun Yat-sen University, Guangzhou 510630, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Oct 30;87(40):2833-6.

PMID:18167286

Abstract

OBJECTIVE

To evaluate the efficacy of ABO-incompatible orthotopic liver transplantation (OLT) in treatment of liver failure.

METHODS

The clinical data of 66 cases of OLT, including 21 cases of ABO-incompatible OLT, for liver failure were retrospectively analyzed.

RESULTS

The 3-month, and 1-, 2-, and 3-year survival rates of the ABO-identical group were 84.2%, 77.4%, 67.6%, and 60.1%, respectively, while those of the ABO-incompatible group were 75.6%, 64.0%, 58.2%, and 58.2%, respectively. The mean survival time of the ABO-identical group was (806.0+/-70.0) d, not significantly different from that of the ABO-incompatible group (720.3+/-118.5 d, P=0.417). The acute rejection rate of the ABO-identical group was 8.9%, not significantly different from that of ABO-incompatible group (9.0%, P=0.253). The biliary tract complication rate and infection rate of the ABO-incompatible group were 76.2% and 28.6% respectively, both significantly higher than those of the ABO-identical group (48.9% and 8.9% respectively, P=0.037 and P=0.038). The major causes of death in the ABO-incompatible group were serious infection (5/21) and renal failure (4/21).

CONCLUSION

ABO-incompatible OLT is an acceptable option to cure liver failure in emergency. Intensive perioperative supervision is essential to improve the effect of ABO-incompatible OLT.

摘要

目的

评估ABO血型不相容原位肝移植（OLT）治疗肝衰竭的疗效。

方法

回顾性分析66例因肝衰竭接受OLT患者的临床资料，其中包括21例ABO血型不相容OLT患者。

结果

ABO血型相同组的3个月、1年、2年和3年生存率分别为84.2%、77.4%、67.6%和60.1%，而ABO血型不相容组分别为75.6%、64.0%、58.2%和58.2%。ABO血型相同组的平均生存时间为（806.0±70.0）天，与ABO血型不相容组（720.3±118.5天，P=0.417）差异无统计学意义。ABO血型相同组的急性排斥反应率为8.9%，与ABO血型不相容组（9.0%，P=0.253）差异无统计学意义。ABO血型不相容组的胆道并发症发生率和感染率分别为76.2%和28.6%，均显著高于ABO血型相同组（分别为48.9%和8.9%，P=0.037和P=0.038）。ABO血型不相容组的主要死亡原因是严重感染（5/21）和肾衰竭（4/21）。