文档介绍：ABO血型不同供肝肝移植的临床应用
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作者:吴凤东吴凤云陈新国臧运金
【摘要】目的: 探讨供受体ABO血型不同肝移植的治疗及效果。方法:回顾性分析15例ABO血型不同肝移植临床资料。血型相容的6例采用常规治疗。血型不相容的9例均于术中显微镜下吻合肝动脉和胆道,术后采用四联免疫治疗方案及抗凝治疗,其中1例术前行血浆置换,5例术中切除脾脏。结果:血型相容的6例无并发症出现。血型不相容的9例中,4例患者顺利恢复,无并发症;其余5例中,3例出现急性排异反应,4例出现胆道非吻合口狭窄,3例死亡。结论:ABO血型不同但相容的供肝肝移植效果良好,血型不相容的供肝肝移植并发症多。当供体缺乏而受者病情不能等待时,可以选择性进行,但应该尽量减少并发症发生。
【关键词】血型不合·ABO血型系统·肝移植
【ABSTRACT】 Objective: To explore the treatment and effect of ABO-different orthotopic liver transplantation(OLT). Methods: Fifteen cases of ABO-different OLT were analyzed retrospectively. Six cases of ABO-different patible OLT were treated routinely. In 9 cases of ABO-patible OLT, plasma exchange was done in 1 case before operation, splenectomy was done in 5 cases during operation, the hepatic artery and biliary duct anastomosis were performed by the microvascular technique. The immuno suppressive protocol included a quadruple drug therapy, and anticoagulant therapy were performed postoperation. Results: plications were found in 6 cases of ABO-different patible OLT. Of the 9 cases of ABO-patible OLT, 4 patients recovered smoothly plications. plications included acute rejection in 3 patients, biliary nonanastomotic stricture in 4 patients, and 3 cases died. Conclusion: The effect ofABO-different patible OLT is good. ABO-patible OLT can be used when the graft is scarce, but we should mana