摘要
目的探讨ABO血型不合的供肝肝移植后的临床治疗措施、疗效及预后。方法2004年1月至2008年1月接受原位肝移植的2188例患者中，有16例为ABO血型不合的肝移植。术前及术后监测此16例患者的血液凝集素效价；术后采用四联免疫抑制方案抗排斥反应；术中有5例行脾切除。术后观察受者的肝功能、急性排斥反应、血管和胆道并发症及术后存活率。结果患者围手术期死亡率为25％（4／16），半年存活率为75％（12／16），1年存活率为37．5％（6／16）。术后发生急性排斥反应3例、感染5例、多器官功能衰竭1例和胆道并发症1例。结论ABO血型不合的肝移植多在紧急状况下实施，患者预后不佳。通过术前及术后综合防治措施，可以减少术后排斥反应的发生，提高存活率。
Objective To evaluate the clinical effect of ABO-incompatible liver transplantation. Methods From Jan. 2004 to Jan. 2008, 16 cases of ABO-incompatible liver transplantation were studied in 2188 liver transplantations. The blood agglutinin titer was monitored and the patients were treated with quadruple immunosuppression therapy perioperatively. Survival rate, liver function recovery, acute rejection, vascular and biliary tract complication were monitored. Results The mortality in perioperative period was 25 % （4/16）. The 6-month survival rate was 75 % （12/16） and l-year survival rate was 37. 5%（6/16）. Postoperative complications included acute rejection in 3 cases, infection in 5 cases, multiple organ failure in 1 case and biliary tract complication in 1 case, respectively. Conclusions The prognosis of patients receiving ABO incompatible liver graft is poor, hence it is often applicable in the setting of emergency. Comprehensive treatments before and after operation contribute to the reduction of rejection occurrence and increase of the survival rate.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2008年第12期709-711,共3页
Chinese Journal of Organ Transplantation
基金
基金项目：CMB（China Medical Boardin NewYork）基金（06837）
关键词
肝移植
AgO血型系统
血型不合
Liver transplantation
ABO blood-group system
Blood group ineompatibility
