PDF(Pubmed)
Abstract：
BACKGROUND The use of ABO-incompatible liver transplants (ABO-ILTs) from deceased donors has become more common due to the shortage of available donor livers and increased transplant waiting times. This retrospective study from a national transplant center at Helsinki University Hospital, Finland, aimed to assess the long-term outcomes of ABO-incompatible deceased donor pediatric liver transplants between 1987 and 2022. MATERIAL AND METHODS Sixteen (9.5%) of the 169 pediatric liver transplantations were ABO-ILTs. The median age at transplantation was 5.0 (0.5-15.4) years. Reasons for ABO-ILTs were acute liver failure (18.75%), malignancy (12.5%), small body size and long waiting time (25%), and other reasons (43.75%). The median post-transplant follow-up time was 147 (0.72-353) months. Patient and graft survival and occurrence of surgical complications were compared to ABO-identical transplants, and anti-ABO antibody titers were analyzed. RESULTS The 1-, 3-, and 5-year patient survivals were comparable between the ABO-I and ABO-compatible groups, being 81.3%, 73.9%, and 73.9% (ABO-I) and 87.5%, 82.5%, 77.9% (ABO-compatible), respectively. Three patients with ABO-ILTs died of sepsis and multiorgan failure during the first 3 months after transplantation. The occurrence of biliary complications and early vascular thrombosis (<30 days after transplantation) did not differ significantly between recipients with an ABO-ILT vs ABO-compatible liver graft. CONCLUSIONS The findings from this study support findings from previous studies that outcomes after ABO-incompatible liver transplants in children were comparable to outcomes from ABO-identical liver transplants.
摘要：
背景技术由于可用供体肝脏的短缺和移植等待时间的增加,来自已故供体的ABO不相容肝移植(ABO-ILT)的使用变得更加普遍。这项来自赫尔辛基大学医院国家移植中心的回顾性研究，芬兰,旨在评估1987年至2022年间ABO不相容的已故供体小儿肝移植的长期结局。材料与方法169例小儿肝移植中16例（9.5％）为ABO-ILTs。移植时的中位年龄为5.0（0.5-15.4）岁。ABO-ILTs的原因是急性肝功能衰竭（18.75％），恶性肿瘤（12.5%），体型小，等待时间长（25%），等原因（43.75%）。移植后随访时间中位数为147(0.72-353)个月。将患者和移植物的存活率以及手术并发症的发生与ABO相同的移植物进行比较，分析抗ABO抗体滴度。结果1-，3-,ABO-I组和ABO相容组的5年患者生存率相当，为81.3%，73.9%,73.9%(ABO-I)和87.5%，82.5%,77.9%（ABO兼容），分别。3例ABO-ILTs患者在移植后的前3个月内死于脓毒症和多器官功能衰竭。在接受ABO-ILT和ABO相容性肝移植的受者之间，胆道并发症和早期血管血栓形成的发生（移植后<30天）没有显着差异。结论这项研究的结果支持以前的研究结果，即儿童ABO不相容肝移植后的结果与ABO相同肝移植的结果相当。
