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ABO不兼容的脏移植:来自印度的单中心体验

Nikita Pawar¹, Vaibhav Tiwari¹, Anurag Gupta¹

¹Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, Delhi, India.

Indian journal of nephrology

|April 22, 2024

概括

与ABO不兼容的移植为缺乏兼容捐赠者的末期病患者提供了一个解决方案. 然而,管理排斥和感染对于成功移植ABOi的结果至关重要.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
移植免疫学移植免疫学
临床医学临床医学

背景情况:

末期病 (ESRD) 是一个重大挑战,因为缺乏相容的器官捐献者.
ABO不兼容 (ABOi) 移植是解决这种供体短缺的可行选择.
在印度的许多中心,对ABOi移植的专业知识有限.

研究的目的:

为了评估ABO不兼容移植的结果.
在ABOi移植接受者中识别常见的并发症和生存率.
评估扩大ABOi移植计划的可行性.

主要方法:

在2012年至2021年期间进行的ABOi脏移植的回顾性分析.
纳入标准:抗ABO抗体 (IgG) 标位≤1:4,脱敏化方案 (利图西马布,血交换,免疫吸收) 和特异性免疫抑制 (塔克罗利斯,甲酸莫菲蒂尔).
手术后的监测包括每天对抗ABO标位进行检查,持续两周.

主要成果:

分析了195名患者的12个月随访数据;平均随访时间为28.9个月.
尿路感染是最常见的并发症 (46.1%).
抗体介导排斥 (ABMR) 发生在15%的患者中,败血症 (包括COVID-19) 是导致死亡的主要原因 (4.6%). 一年后患者的存活率为86.6%,死亡审查的移植存活率为89.3%.

结论:

对于ESRD患者没有兼容的捐赠者来说,ABOi移植是关键的选择.
更高的排斥率和感染率需要谨慎的管理策略.
需要进一步发展和传播专业知识,以扩大对ABOi移植的准入.

关键词:

不兼容的 ABO 不兼容的 ABO.感染的感染感染.拒绝拒绝拒绝拒绝移植移植移植移植移植移植

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