父母供肝对1岁内儿童活体肝移植术后早期急性细胞排斥反应的影响  

Effect of parental donor liver on early acute cellular rejection after live donor liver transplantation in infants

作　　者：焦利俊 董冲[1] 王凯[1] 孙超[1] 张威[1] 郑卫萍[1] 王振[1] 解恩博 徐敏 高伟[1] Jiao Lijun;Dong Chong;Wang Kai;Sun Chao;Zhang Wei;Zheng Weiping;Wang Zhen;Xie Enbo;Xu Min;Gao Wei(Department of Children's Organ Transplantation,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院儿童器官移植科,天津300192

出　　处：《中华器官移植杂志》2023年第3期167-171,共5页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金(82170672)。

摘　　要：目的探讨父母供肝对1岁以内儿童肝移植术后早期(≤3个月)急性细胞排斥反应(ACR)的影响。方法回顾性分析2018年1月至2021年1月天津市第一中心医院行儿童活体肝移植的362例1岁以内儿童受者及相应供者的临床资料,按供肝来源分为父亲供肝组(156例)与母亲供肝组(206例),分析两组供受者的临床特征、术后急性细胞性排斥反应(acute cellular rejection,ACR)发生的相关差异性。结果362例受者中,父亲供肝156例,母亲供肝206例,术后早期ACR发生率为14.9%(54/362),其中父亲供肝组ACR发生率为20.5%(32/156),母亲供肝组ACR发生率为10.7%(22/206),差异有统计学意义(λ2=6.763,P=0.009)。在供受者性别匹配情况分析中,女性受者父亲供肝组的ACR发生率为22.6%,母亲供肝组的ACR发生率为10.3%,差异有统计学意义(λ2=5.411,P=0.020)。父亲供肝组术后发生首次ACR的中位时间为13.00 d,范围在(8.25~20.25)d,母亲供肝组的中位时间为17.00 d,范围在9.00~28.25 d,差异均无统计学意义(P>0.05),两组ACR均以轻中度为主。结论在1岁以内儿童活体肝移植中,母亲供肝术后早期ACR发生率低于父亲供肝,在女性受者中更加显著。Objective To evaluate the effect of parental liver donation on early acute cellular rejection(ACR)after liver transplantation(LT)in children aged under one year.Methods From January 2018 to January 2021,retrospective review is conducted for clinical data of living donor LT recipients and donors aged under 1 year at Tianjin First Central Hospital.Donor livers are assigned into two groups of paternal donor liver(156 cases)and maternal donor liver(206 cases)according to the source of donor liver,Clinical characteristics and postoperative ACR occurrence of two groups are analyzed.Results The rates of ACR during early postoperative period is 14.9%(54/362),20.5%(32/156)in paternal liver donor group and 10.7%(22/206)in maternal liver donor group.There is statistically significant difference(λ2=6.763,P=0.009).In analysis of gender matching of donor recipients,the rates of ACR is 22.6%in paternal donor group and 10.3%in maternal donor group.There is statistically significant difference(λ2=5.411,P=0.020).Median time of initial postoperative ACR is 13.00(8.25~20.25)day in paternal liver donor group and 17.00(9.00~28.25)day in maternal donor group.The difference is not statistically significant(P>0.05).ACR is mostly mild-to-moderate in two groups.Conclusions In living donor LT for children aged under 1 year,the rates of early ACR is lower for maternal donor than that for paternal donor,especially in female recipients.

关 键 词：肝移植 儿童 活体供肝 急性细胞性排斥反应 

分 类 号：R726.5[医药卫生—儿科]