中国两例不进行血浆置换的同时性ABO血型不相容活体肝移植及脾切除术病例报告。
Simultaneous ABO-incompatible living-donor liver transplantation and splenectomy without plasma exchange in China: Two case reports.
作者信息
Chen Guoyong, Sun Janjun, Wei Sidong, Chen Yongfeng, Tang Gaofeng, Xie Zhantao, Xu Huaen, Chen Janbin, Zhao Huibo, Yuan Zhenhua, Wang Weiwei, Liu Guangbo, Wang Bing, Niu Biao
机构信息
1 Department of Hepatobiliary and Pancreatic Surgery, People's Hospital, Zhengzhou University, Zhengzhou, China.
2 Department of Hepatobiliary and Pancreatic Surgery, Zhengzhou People's Hospital, Southern Medical University, Zhengzhou, China.
出版信息
J Int Med Res. 2017 Dec;45(6):2146-2152. doi: 10.1177/0300060517710407. Epub 2017 Jun 21.
ABO-incompatible (ABO-i) living-donor liver transplantation (LDLT) is performed if an ABO-compatible graft cannot be obtained. However, a perfect desensitization protocol has not been established worldwide, especially for simultaneous ABO-i LDLT and splenectomy. We herein report two cases of ABO-i LDLT. To the best of our knowledge, this is the first case report of ABO-i LDLT in an adult patient in China. Splenectomy and T-cell-targeted immunosuppression (basiliximab) was used to overcome the blood group barrier in these recipients. The patients had good graft function without signs of antibody-mediated rejection throughout the 12-month follow-up. Thus, ABO-i LDLT with splenectomy is undoubtedly life-saving when an ABO-compatible graft cannot be obtained for patients in critical condition.
如果无法获得 ABO 血型相容的供肝，则进行 ABO 血型不相容（ABO-i）活体肝移植（LDLT）。然而，目前全球尚未建立完善的脱敏方案，尤其是对于同期 ABO-i LDLT 和脾切除术而言。我们在此报告两例 ABO-i LDLT 病例。据我们所知，这是中国首例成人 ABO-i LDLT 病例报告。在这些受者中，采用脾切除术和靶向 T 细胞的免疫抑制（巴利昔单抗）来克服血型障碍。在为期 12 个月的随访中，患者移植肝功能良好，未出现抗体介导排斥反应的迹象。因此，对于病情危急且无法获得 ABO 血型相容供肝的患者，ABO-i LDLT 联合脾切除术无疑是挽救生命的方法。
Zotero 插件