ABO血型不合供肝在肝移植中的应用  

Application of liver grafts from ABO incompatible donor

作　　者：江春平[1] 丁义涛[1] 徐庆祥[1] 吴亚夫[1] 

机构地区：[1]南京大学医学院附属鼓楼医院肝胆外科,江苏南京210008

出　　处：《实用器官移植电子杂志》2013年第1期27-30,共4页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：卫生部科研课题(LW201008);江苏省十二五"兴卫工程"(ZX201105);国家高技术研究发展计划(863)项目(2011AA020104)

摘　　要：目的探讨ABO血型不合供肝在肝移植的应用对术后肝功能和预后的影响及围手术期的处理经验。方法分析南京大学医学院附属鼓楼医院2008年1月至2011年12月ABO血型不合供肝8例,随机选择同期ABO血型相合供肝10例作为对照组,分别监测肝移植术后受体肝功能、凝血酶原时间(PT)、住重症监护病房(ICU)时间,排斥反应、胆道并发症、感染、移植肝功能不良或无功能(IPF/PNF)发生率和患者1年生存率等指标。结果上述指标ABO血型不合供肝组与对照组比较差异均无统计学意义(均P>0.05)。结论在没有合适供肝的情况下,谨慎使用ABO血型不合供肝,辅以适当的围手术期处理,其治疗结果可与正常供肝组相近。Objective To discuss the effect of ABO incompatible donor on postoperative liver function and prognosis in liver transplantation and to share our experience of perioperative care in these cases. Methods We analyzed 8 ABO incompatible donor liver transplantation cases carried out in the Affiliated Drum Tower Hospital of Nanjing University Medical College from January 2008 to December 2011 and compared with 10 control cases of ABO compatible donor liver transplantation. Postoperative liver function,prothrombin time(PT),intensive care unit(ICU)stay days,the incidence of rejection,biliary tract complication,infection, donor liver initial poor function/primary nonfunction(IPF/PNF)and 1 year survival rate were summarized and compared between marginal donor cases and control cases. Results We found no significant difference between ABO incompatible donor cases and ABO compatible donor cases in all above analyzed parameters (all P>0.05). Conclusion With proper perioperative care,the application of ABO incompatible donor liver in the situation of organ shortage may have similar therapeutic efficacy as ABO compatible donor liver transplantation.

关 键 词：肝移植 ABO血型不合供肝 排斥反应 生存率 

分 类 号：R657.3[医药卫生—外科学]