Zhou Jian, Ju Weiqiang, Yuan Xiaopeng, Jiao Xingyuan, Zhu Xiaofeng, Wang Dongping, He Xiaoshun
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Transpl Int. 2015 Jul;28(7):793-9. doi: 10.1111/tri.12531. Epub 2015 Feb 17.
Effect of ABO-incompatible liver transplantation on patients with severe hepatitis B (SHB) remains unclear. Herein, we summarized 22 cases with SHB in whom were performed emergency liver transplantation from ABO-incompatible donors. The immunosuppressive protocol consisted basiliximab, tacrolimus, steroids and mycophenolate mofetil. The mean MELD score was 35.2 ± 7.1. Major complications included rejection, infections, biliary complications, hepatic artery thrombosis or stenosis and portal vein thrombosis. Patient survival rates were 40.9%, 78.9% and 82.3% in 1 year, 29.2%, 66.8% and 72.9% in 3 years, and 21.9%, 60.1% and 62.5% in 5 years for ABO-incompatible, ABO-compatible and ABO-identical groups. Graft survival rates were 39%, 78.9% and 82.3% in 1 year, 27.8%, 66.4% and 71.1% in 3 years, and 20.9%, 57.9% and 61.0% in 5 years for incompatible, compatible and identical ABO graft-recipient match. The 1-, 3-, 5-year graft and patient survival rates of ABO-incompatible were distinctly lower than that of ABO-compatible group (P < 0.05). Our results suggested that ABO-incompatible liver transplantation might be a life-saving procedure for patients with SHB as a promising alternative operation when ABO-compatible donors are not available and at least bridges the second opportunity for liver retransplantation.
ABO血型不相容肝移植对重型乙型肝炎（SHB）患者的影响尚不清楚。在此，我们总结了22例接受ABO血型不相容供体紧急肝移植的SHB患者。免疫抑制方案包括巴利昔单抗、他克莫司、类固醇和霉酚酸酯。平均终末期肝病模型（MELD）评分是35.2±7.1。主要并发症包括排斥反应、感染、胆道并发症、肝动脉血栓形成或狭窄以及门静脉血栓形成。ABO血型不相容组、ABO血型相容组和ABO血型相同组的患者1年生存率分别为40.9%、78.9%和82.3%，3年生存率分别为29.2%、66.8%和72.9%，5年生存率分别为21.9%、60.1%和62.5%。ABO血型不相容、ABO血型相容和ABO血型相同的供受体匹配组的移植物1年生存率分别为39%、78.9%和82.3%，3年生存率分别为27.8%、66.4%和71.1%，5年生存率分别为20.9%、57.9%和61.0%。ABO血型不相容组的1年、3年、5年移植物和患者生存率明显低于ABO血型相容组（P<0.05）。我们的结果表明，ABO血型不相容肝移植对于SHB患者可能是一种挽救生命的手术，在没有ABO血型相容供体时是一种有前景的替代手术，并且至少为再次肝移植提供了第二次机会。
