ABO血型不合肝移植研究新进展

Development of ABO-incompatible liver transplantation

复习国外文章关于ABO血型不相同的肝脏移植在A2型供肝使用，移植肝出现受体类型的ABO组织血型抗原，C4d作用和临床治疗上的新进展。A2型供肝能较安全的用于血型不合肝移植，毛细血管内表达r-ABOAg可能是移植物内皮损害和修复的表现，C4d阳性对血型不同肝移植治疗策略上是很好的参考物，但缺乏特异性，采用包括多联免疫抑制药和肝内灌注等综合治疗方法能有效预防排斥反应且能取得良好的预后。

To summarize the the development of A2 donors, recipient-type ABO blood group antigens, CAd and clinical strategy for ABO-incompatible liver transplantation. It seems that the A2 to O combination in liver transplantation is safe and can also be considered to use in elective ABO-incompatible cases. The cause of recipient-type ABO blood group antigens in graft possible include injury and repair reactions and true endothelial cell chimerism. C4d can be a hallmark of acute humoral rejection in ABO-incompatible liver transplantation, but its specificity still needs to explore. Combined therapy including Rituximab prophylaxis and HA infusion therapy and so on can effectively prevent clinical HR and attain satisfactory prognosis.