淋巴细胞毒交叉配合试验阳性并不会对活体肝移植受者的生存造成不良影响。
Positive lymphocytotoxic crossmatch does not adversely affect survival in living donor liver transplantation.
机构信息
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
出版信息
Dig Surg. 2009 Feb;26(6):482-6. doi: 10.1159/000253873. Epub 2010 Jan 8.
BACKGROUND/AIMS: The influence of lymphocytotoxic crossmatch on survival or acute rejection in liver transplantation remains controversial. Data regarding graft survival and acute rejection of living donor liver transplantation (LDLT) are limited.
METHODS
We retrospectively examined the influence of a positive T or B lymphocytotoxic crossmatch on survival and acute rejection in patients using a database of 414 consecutive LDLT cases.
RESULTS
The rejection-free rate at 90 days after LDLT was lower in patients that were T crossmatch-positive compared to patients that were both T and B crossmatch-negative (52 vs. 74%, p = 0.03). No patients with a positive lymphocytotoxic crossmatch died due to immunologic causes. The crossmatch results had no effect on graft survival.
CONCLUSION
In the positive crossmatch groups, there was no acute rejection that was untreatable or that caused graft loss. These findings indicate that a positive crossmatch graft should not be considered a contraindication for LDLT.
背景/目的：淋巴细胞毒性交叉配型对肝移植患者的存活或急性排斥反应的影响仍存在争议。关于活体供肝移植（LDLT）的移植物存活率和急性排斥反应的数据有限。
方法
我们通过 414 例连续 LDLT 病例的数据库，回顾性地检查了 T 或 B 淋巴细胞毒性交叉配型阳性对患者生存和急性排斥反应的影响。
结果
与 T 和 B 淋巴细胞交叉配型均阴性的患者相比，T 淋巴细胞交叉配型阳性的患者在 LDLT 后 90 天的无排斥反应率较低（52%比 74%，p=0.03）。没有因免疫原因而死亡的患者出现阳性淋巴细胞毒性交叉配型。交叉配型结果对移植物存活率没有影响。
结论
在阳性交叉配型组中，没有不可治疗或导致移植物丢失的急性排斥反应。这些发现表明，阳性交叉配型的移植物不应被视为 LDLT 的禁忌证。
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