不兼容ABO的肝移植是利用不足的资源,以改善获得肝移植的机会
Angela L Hill1, Amen Z Kiani1, Neeta Vachharajani1
1Section of Abdominal Transplantation, Division of General Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, MO 63110.
Transplantation proceedings
|November 7, 2025
概括
在对患者因素进行调整后,ABO不兼容 (ABOi) 的肝脏移植显示与ABO兼容 (ABOc) 和ABO相同 (ABOid) 移植的结果相似. ABOi肝移植可以改善获得及时肝移植捐赠的机会.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植免疫学 移植免疫学
- 外科手术的结果
背景情况:
- 从历史上看,ABO不兼容 (ABOi) 肝移植 (LT) 的结果较差.
- 这项研究重新评估了ABOi LT作为未充分利用的肝移植的潜在来源.
研究的目的:
- 评估 ABOi 肝移植与 ABO 兼容 (ABOc) 和 ABO 相同 (ABOid) 移植相比的结果.
- 确定ABOi肝移植是否是增加移植可用性的可行选择.
主要方法:
- 从1987年到2022年,对成人和儿科肝脏移植的回顾性审查.
- 患者被分为ABO不兼容 (ABOi),兼容 (ABOc) 和相同 (ABOid) 的组.
- 1:1:1的倾向分数根据接受者的年龄和敏度进行匹配.
主要成果:
- 在倾向匹配后,在ABOi,ABOc和ABOid组之间没有观察到移植存活率 (GS),整体存活率 (OS) 或再移植率的显著差异.
- 不匹配的分析显示,ABOi的结果更差,这凸显了考虑受益人因素的重要性.
- 呈现的ABOi接受者具有更高的敏度 (MELD/PELD得分) 和列表优先级.
结论:
- 当考虑接受者因素时,ABOi肝移植产生了与ABOc和ABOid移植相似的结果.
- ABOi LT可以帮助减少器官分配中的血型差异.
- 扩大ABOi LT可以改善及时获得肝移植的机会.
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