ABO血型不相容的活体供肝移植中的免疫策略及结果
Immunologic strategies and outcomes in ABO-incompatible living donor liver transplantation.
作者信息
Oh Jongwook, Kim Jong Man
机构信息
Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Clin Mol Hepatol. 2020 Jan;26(1):1-6. doi: 10.3350/cmh.2019.0023. Epub 2019 Mar 26.
Abstract
Antibody mediated rejection (AMR) after adult ABO-incompatible living donor liver transplantation (ABO-I LDLT) induced hepatic necrosis or diffuse intrahepatic biliary complications, which were related with poor graft and patient survival. Various desensitization protocols have been used to overcome these problems. Since using rituximab, the outcomes of ABO-I LDLT show a similar survival rate to those of ABO-compatible living donor liver transplantation. However, diffuse bile duct complications still occur after ABO-I LDLT. We have reviewed the past and current immune strategies for desensitization and to provide outcomes and ABO incompatibility-related complications in ABO-I LDLT.
摘要
成人ABO血型不相容活体肝移植（ABO-I LDLT）后的抗体介导排斥反应（AMR）可引发肝坏死或弥漫性肝内胆管并发症，这与移植物和患者的不良生存情况相关。已采用多种脱敏方案来克服这些问题。自使用利妥昔单抗以来，ABO-I LDLT的结局显示出与ABO血型相容活体肝移植相似的生存率。然而，ABO-I LDLT后仍会发生弥漫性胆管并发症。我们回顾了过去和当前用于脱敏的免疫策略，并阐述了ABO-I LDLT的结局及与ABO血型不相容相关的并发症。
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本文引用的文献
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Hepatobiliary Pancreat Dis Int. 2018 Apr;17(2):119-125. doi: 10.1016/j.hbpd.2018.02.005. Epub 2018 Feb 19.
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ABO-incompatible Living Donor Liver Transplantation With Rituximab and Total Plasma Exchange Does Not Increase Hepatocellular Carcinoma Recurrence.ABO 不相容活体供肝移植联合利妥昔单抗和全血浆置换不会增加肝细胞癌复发。
Transplantation. 2018 Oct;102(10):1695-1701. doi: 10.1097/TP.0000000000002154.
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Outcome of ABO-incompatible adult living-donor liver transplantation for patients with hepatocellular carcinoma.ABO 不相容成人活体肝移植治疗肝细胞癌患者的结局。
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Transplant Proc. 2016 May;48(4):1134-8. doi: 10.1016/j.transproceed.2016.02.040.
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Case-matched comparison of ABO-incompatible and ABO-compatible living donor liver transplantation.ABO 不相容与 ABO 相容活体供肝移植的病例对照比较。
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ABO-Incompatible Adult Living Donor Liver Transplantation Under the Desensitization Protocol With Rituximab.在使用利妥昔单抗的脱敏方案下进行的ABO血型不相合成人活体肝移植
Am J Transplant. 2016 Jan;16(1):157-70. doi: 10.1111/ajt.13444. Epub 2015 Sep 15.
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Results of ABO-incompatible liver transplantation using a simplified protocol at a single institution.在单一机构使用简化方案进行ABO血型不相容肝移植的结果。
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