Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China.
Curr Pharm Des. 2020;26(28):3406-3417. doi: 10.2174/1381612826666200506094539.
ABO-incompatible (ABO-I) liver transplantation (LT) has been limited due to the increased rate of complications, including severe cellular and antibody-mediated rejection, hepatic necrosis, hepatic artery thrombosis, and biliary complications. However, several strategies for reducing preformed anti-donor ABO antibodies and B cell desensitization have improved the outcomes of ABO-I LT. As a result, ABO-I LT has become a routine procedure and is a feasible option in countries with a scarce deceased-organ donation or in cases without an available compatible organ donor. In this review, we describe past and present desensitizing protocols as well as emergent therapies for depleting B cell and anti-ABO antibodies with the objective of identifying approaches that could lead to new, refined strategies for maximizing the results of ABO-I LT.
ABO 不相容（ABO-I）肝移植（LT）由于并发症发生率增加而受到限制，包括严重的细胞和抗体介导的排斥反应、肝坏死、肝动脉血栓形成和胆并发症。然而，一些降低预先形成的抗供体 ABO 抗体和 B 细胞脱敏的策略已经改善了 ABO-I LT 的结果。因此，ABO-I LT 已成为常规程序，并且在供体器官稀缺或没有可用相容供体器官的情况下是一种可行的选择。在这篇综述中，我们描述了过去和现在的脱敏方案以及用于耗尽 B 细胞和抗 ABO 抗体的新兴疗法，目的是确定可能导致新的、更精细的 ABO-I LT 结果最大化策略的方法。
