Department of Hepatobiliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Surg Today. 2011 Mar;41(3):317-22. doi: 10.1007/s00595-010-4437-3. Epub 2011 Feb 23.
Based on the concept that the liver is a "privileged organ," which resists acute rejection, Thomas Starzl introduced liver transplantation across the ABO blood group. However, with improved survival after liver transplantation came reports of an increased incidence of acute rejection, biliary and vascular complications, and decreased survival after ABO-incompatible liver transplantation. As a result, ABO-incompatible liver transplantations are performed only in emergencies when ABO-compatible grafts are unavailable. In living-donor liver transplantation (LDLT), donors are restricted to family members; therefore, breaking ABO blood group barriers becomes inevitable. This inevitable situation has forced liver transplant surgeons to exploit many innovative techniques to overcome the challenges of ABO-incompatible liver transplantation. This review looks at the history and current practices of ABO-incompatible LDLT to provide insight so that the protocol can be improved further.
基于肝脏是“特权器官”、能抵抗急性排斥反应的概念，Thomas Starzl 提出了 ABO 血型不相容的肝移植。然而，随着肝移植后生存率的提高，报告显示急性排斥反应、胆道和血管并发症的发生率增加，以及 ABO 不相容肝移植后生存率降低。因此，只有在无法获得 ABO 相容移植物的紧急情况下，才会进行 ABO 不相容肝移植。在活体供肝移植（LDLT）中，供者仅限于家庭成员；因此，打破 ABO 血型障碍是不可避免的。这种不可避免的情况迫使肝移植外科医生采用许多创新技术来克服 ABO 不相容肝移植的挑战。本综述回顾了 ABO 不相容 LDLT 的历史和现状，以提供深入了解，从而进一步改进方案。
