Hwang Jeong Kye, Kim Sang Il, Choi Bum Soon, Yang Cheol Woo, Kim Yong Soo, Moon In Sung, Kim Ji Il
Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 Jul;81(1):10-8. doi: 10.4174/jkss.2011.81.1.10. Epub 2011 Jul 11.
ABO incompatible (ABOi) kidney transplantation (KT) has been increasing to compensate for the shortage of organ donors. However, detailed comparative analyses of ABOi KT with ABO compatible (ABOc) KT are still rare.
This retrospective study compared 12 consecutive ABOi KTs to 50 ABOc KTs that employed the same maintenance immunosuppressive agents during the same period. Comparisons of patient survival, graft survival, graft function, and complications were made until post-transplant day 90.
Baseline characteristics of the two groups were similar except for the positivity of panel reactive antibody (12% in the ABOc group vs. 42% in the ABOi group; P = 0.029). There were no significant differences in patient survival, graft survival, post-operative renal function, incidence of acute rejection, infections, or medical and surgical complications. However, bleeding complications were more common in the ABOi group (25%) than versus the ABOc group (6%) (P = 0.08). The preoperative and total hospital stay of the ABOi patients was significantly longer than the ABOc patients (P = 0.001).
ABOi KT is a viable and safe option for patients whose only donor is blood incompatible, despite the longer preoperative hospital stay for preparation.
为弥补器官供体短缺,ABO血型不相容(ABOi)肾移植(KT)的数量一直在增加。然而,对ABOi KT与ABO血型相容(ABOc)KT进行详细的比较分析仍然很少见。
这项回顾性研究将连续12例ABOi KT与同期采用相同维持免疫抑制剂的50例ABOc KT进行了比较。对患者生存率、移植物生存率、移植物功能和并发症进行比较,直至移植后第90天。
除群体反应性抗体阳性外,两组的基线特征相似(ABOc组为12%,ABOi组为42%;P = 0.029)。患者生存率、移植物生存率、术后肾功能、急性排斥反应发生率、感染率以及内科和外科并发症方面均无显著差异。然而,ABOi组的出血并发症(25%)比ABOc组(6%)更常见(P = 0.08)。ABOi患者的术前住院时间和总住院时间明显长于ABOc患者(P = 0.001)。
对于唯一供体血型不相容的患者,ABOi KT是一种可行且安全的选择,尽管术前准备的住院时间较长。