Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Clin Transplant. 2018 Jul;32(7):e13284. doi: 10.1111/ctr.13284. Epub 2018 Jun 20.
There are limited data on the outcomes of pancreas transplants using ABO non-identical but compatible (NIC) donors.
A review of all pancreas transplants from a single institution from 01/2003 to 07/2016 (n = 606) revealed 41 recipients of a NIC donor pancreas which were matched for age, race, gender, year, and type of transplant with 41 ABO identical cases. Groups were compared for allograft survival, incidence of acute cellular rejection (ACR), length of hospital stay, 3-month readmissions and transfusion requirements. Serum haptoglobin and lactate dehydrogenase were used to identify hemolysis in patients requiring repeated transfusions without overt blood loss.
The 1-year graft survival was 100% and 88% in the study and control groups. In the study group, 6/41(14%) developed hemolysis, all of which were ABO O into A. All responded to donor blood type specific transfusions.
There are limited data on outcomes of solid organ transplant using NIC donors with almost none specifically addressing pancreas transplantation. In this study, graft survival was similar but 14% developed hemolysis, which was transient and treated with transfusion of donor blood type specific blood.
Non-identical but compatible pancreas transplants have similar graft survival compared to ABO identical. Hemolysis may occur so some caution is required.
关于使用 ABO 非同型但相容（NIC）供体的胰腺移植结局的数据有限。
对 2003 年 1 月至 2016 年 7 月期间来自一家机构的所有胰腺移植（n=606）进行回顾，发现有 41 例 NIC 供体胰腺移植受者，他们的年龄、种族、性别、年份和移植类型与 41 例 ABO 相同的病例相匹配。比较两组移植物存活率、急性细胞排斥（ACR）发生率、住院时间、3 个月再入院率和输血需求。血清结合珠蛋白和乳酸脱氢酶用于识别反复输血但无明显失血的患者的溶血。
研究组和对照组的 1 年移植物存活率分别为 100%和 88%。在研究组中，6/41（14%）发生溶血，均为 ABO O 型进入 A 型。所有患者均对供体血型特异性输血有反应。
使用 NIC 供体的实体器官移植结果的数据有限，几乎没有专门针对胰腺移植的研究。在这项研究中，移植物存活率相似，但 14%的患者发生溶血，且为一过性，通过输注供体血型特异性血液进行治疗。
非同型但相容的胰腺移植与 ABO 相同的移植相比，移植物存活率相似。可能会发生溶血，因此需要谨慎。
