印度儿童的 ABO 不相容的移植
Jitendra Meena1, Aditi Sinha1, Menka Yadav1
1Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Pediatric transplantation
|September 24, 2025
概括
在印度,儿童的ABO不兼容 (ABOi) 移植是可行的,与ABO兼容 (ABOc) 移植相比,显示出相似的移植存活率和患者结果. 这种方法扩大了儿童脏接受者的捐赠池.
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
- 儿科外科手术 儿科外科手术
背景情况:
- 发展中国家的移植严重依赖于活体捐赠者,导致缺乏ABO兼容 (ABOc) 捐赠者的患者延长等待列表.
- ABO不兼容 (ABOi) 移植提供了一个可行的策略,以扩大捐赠者池.
- 这项研究详细介绍了该中心对儿科ABOi脏移植的经验.
研究的目的:
- 评估ABO互不兼容 (ABOi) 移植在儿童中的可行性和结果.
- 为了比较ABOi移植与ABO兼容 (ABOc) 移植在儿科队列中的结果.
- 为了评估移植后的移植存活率,患者存活率和功能.
主要方法:
- 对2019年1月至2023年12月期间进行的儿科移植 (ABOi和ABOc) 病历的回顾性分析.
- 针对ABOi受体的脱敏化方案包括rituximab,免疫吸收或血交换,以及IVIg.
- 诱导疗法使用了巴西西西马布或ATG,然后用塔克罗利斯,美酸莫菲蒂尔和普雷迪尼索隆进行维持免疫抑制.
主要成果:
- 在五年内进行了7次ABOi和46次ABOc脏移植,患者和捐赠者的特征相似.
- 在ABOi和ABOc组之间,无排斥的移植存活率与ABOi和ABOc组相似 (p=0.88).
- 在最后一次随访时,估计的小球膜过率 (eGFR) 的中位数是可比的 (61.4 ml/min/1.73 m2在ABOi和50.9 ml/min/1.73 m2在ABOc; p=0.23),患者和移植的生存率相似.
结论:
- 印度的儿科ABO不相容的脏移植是一种可行的手术.
- 结果,包括移植存活率和功能,是令人满意的,可与ABO兼容移植相比较.
- ABOi移植有效地扩大了需要移植的儿童的捐赠者选择.
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