在不兼容的活体捐赠者脏移植接受者的术后事件 接受先前无敏化
Rubén García-Sobrino1, Dario Vazquez-Martul2, Constantino Fernández-Rivera3
1Department of Urology, Hospital Ribera Povisa, Vigo, España.
Transplantation proceedings
|July 16, 2023
概括
活体捐赠者的脏移植与ABO不兼容或HLA不兼容的捐赠者需要更多的输血和更大的血瘤,导致更高的再干预率. 然而,整体手术并发症数量在不兼容和兼容的接受者之间没有显著差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 免疫学 免疫学 免疫学
背景情况:
- 活体供体移植 (LDKT) 是慢性衰竭的首要治疗方法.
- ABO和/或HLA不兼容性约占LDKT病例的三分之一.
- 移植前无敏化计划的目的是克服免疫学障碍.
研究的目的:
- 为了比较ABO-不兼容 (ABOi) 和HLA-不兼容 (HLAi) 接受移植的接受者的手术并发症和出血事件.
- 评估不兼容接受者的结果与ABO-兼容 (ABOc) 接受者的结果.
主要方法:
- 对62名ABOi和HLAiLDKT接受者的回顾性分析 (2009-2019).
- 与62名连续执行的ABOc LDKT接受者进行比较.
- 分析手术并发症,周移植血瘤 (存在,大小,重新干预) 和术后输血.
主要成果:
- 不相容的接受者 (ABOi + HLAi) 显示出更多的周移植血瘤的数量和大小.
- 在不相容的组中观察到更高的手术再干预率和更多的输血.
- 在不兼容和兼容的接受者之间,没有发现整体手术并发症率的统计学上显著差异.
结论:
- 无敏化移植接受者经历了更多的术后出血并发症,包括更大的血瘤和增加对输血和重新干预的需求.
- 尽管出血事件增加,但整体手术并发症的数量没有显著差异.
- 移植前的脱敏方案是有效的,但需要仔细管理相关的出血风险.
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