ABO血型不相容肝移植的可行性  

Feasibility of ABO-incompatible liver transplantation

作　　者：林建华[1] 周杰[1] 张起帆[1] 林艺雄[1] 

机构地区：[1]南方医科大学南方医院肝胆外科,广东省广州市510515

出　　处：《中国组织工程研究与临床康复》2010年第44期8196-8198,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:为了缩短等待供肝的时间,使患者能够获得移植及术后生存的机会,结合近年来血型不相容肝移植的良好临床效果,试图进行供受者ABO血型不相容的肝移植。目的:分析ABO血型不相容肝移植的临床效果及可行性。方法:回顾2005-11/2010-01南方医科大学南方医院肝胆外科7例ABO血型不相容肝移植病例的临床资料,分析其临床效果、主要并发症和治疗措施的改进,探讨ABO血型不相容肝移植的可行性。结果与结论:例1术后发生胆道狭窄并发症,经置放胆管内外引流管支撑2年后造影提示胆道通畅后拔除,至今无胆道狭窄表现;例4于术后5个月余因肿瘤全身多处转移死亡外,其余6例均存活良好;例7于术后1周出现胆红素异常升高,考虑为急性排斥反应,予甲强龙冲击治疗后逐渐恢复正常。提示,对肝功能衰竭及中晚期肝癌患者,为了缩短等待供肝的时间,使此类患者能够获得移植及术后生存的机会,实施ABO血型不合的肝移植是可行的。BACKGROUND：According to its fine clinical results reported in recent years, ABO blood type in-compatible liver transplantation can be performed in order to shorten the time of waiting for donors, which gives this kind of patients the opportunity to receive liver transplantation and survive.OBJECTIVE：To study the clinical effect and feasibility of ABO-incompatible liver transplantation.METHODS：Data of 7 patients, who had performed ABO-incompatible liver transplantation in Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University from November 2005 to January 2010, were reviewed.Discussions were focused on the clinical effect and main complications and treatment measures improving, in order to analyze the feasibility of ABO-incompatible liver transplantation.RESULTS AND CONCLUSION：There was bile duct stenosis in case 1 after operation.Bile exterior and interior pedestal drainage tube was set until cholangiography demonstrated that the bile duct was unobstructed and the drainage tube was removed 2 years later.Up to now there is no evidence of bile duct obstruct.Only case 4 died at five months postoperative due to the tumor metabases, other 6 patients survived well.Acute rejection was occurred in case 7 at 1 week postoperative on account of the abnormal rising of serum bilirubin level, urbason therapy was performed immediately and the serum bilirubin was decreased gradually to normal.There were no complications in other patients.ABO-incompatible liver transplantation is feasible for patients in emergency or other special conditions.

关 键 词：肝移植 ABO血型 不相容 急性排斥反应 并发症 

分 类 号：R617[医药卫生—外科学]