Background:The shortage of donor liver restricts liver transplantation(LT).Nowadays,donor liver with ABO blood group incompatibility between donor and recipient has become an option to expand the source of donor liver...Background:The shortage of donor liver restricts liver transplantation(LT).Nowadays,donor liver with ABO blood group incompatibility between donor and recipient has become an option to expand the source of donor liver.Although it is now possible to perform ABO-incompatible(ABO-I)LT,antibody-mediated rejection(AMR)has been recognized as the primary cause of desperate outcomes after ABO-I LT.Anti-A/B antibody is the trigger of immune response to ABO-I LT graft injury.Therapeutic plasma ex-change(TPE)can quickly reduce the titer of plasma antibodies and effectively inhibit humoral immunity.Data sources:We searched PubMed and CNKI databases using search terms“therapeutic plasma ex-change”,“ABO-incompatible liver transplantation”,“ABO-I LT”,“liver transplantation”,“LT”,“antibody-mediated rejection”,and“AMR”.Additional publications were identified by a manual search of references from key articles.The relevant publications published before September 30,2020 were included in this review.Results:Different centers have made different attempts on whether to use TPE,when to use TPE and how often to use TPE.However,the control standard of lectin revision level is always controversial,the target titer varies significantly from center to center,and the standard target titer has not yet been estab-lished.TPE has several schemes to reduce antibody titers,but there is a lack of clinical trials that provide standardized procedures.Conclusions:TPE is essential for ABO-I LT.Hence,further research and clinical trials should be conducted to determine the best regimen for TPE to remove ABO antibodies and prevent AMR.展开更多
目的观察莲黄汤治疗母儿ABO血型不合的临床疗效。方法对60例母儿ABO血型不合的孕妇随机分为两组,A组采用莲黄汤加减治疗,B组采用西医治疗,随访疗效。结果两组抗体效价均有不同程度的下降,A组有效率为90.0%,B组有效率为56.7%。A组新生儿...目的观察莲黄汤治疗母儿ABO血型不合的临床疗效。方法对60例母儿ABO血型不合的孕妇随机分为两组,A组采用莲黄汤加减治疗,B组采用西医治疗,随访疗效。结果两组抗体效价均有不同程度的下降,A组有效率为90.0%,B组有效率为56.7%。A组新生儿平均脐血胆红素低于B组,差异有统计学意义(P<0.01)。两组新生儿5 min Apgar评分、体重及脐血血红蛋白含量差异均无统计学意义(P>0.05)。结论莲黄汤治疗母儿ABO血型不合有较好的疗效,能有效降低其血清抗体效价,预防产后新生儿ABO溶血病的发生。展开更多
基金the National Nat-ural Science Foundation of China(81625003,81800578,and 81930016)Key Research&Development Plan of Zhejiang Province(2019C03050 and 2021C03118)Projects of Medical and Health Technology Program in Zhejiang Province(WKJ-ZJ-2120).
文摘Background:The shortage of donor liver restricts liver transplantation(LT).Nowadays,donor liver with ABO blood group incompatibility between donor and recipient has become an option to expand the source of donor liver.Although it is now possible to perform ABO-incompatible(ABO-I)LT,antibody-mediated rejection(AMR)has been recognized as the primary cause of desperate outcomes after ABO-I LT.Anti-A/B antibody is the trigger of immune response to ABO-I LT graft injury.Therapeutic plasma ex-change(TPE)can quickly reduce the titer of plasma antibodies and effectively inhibit humoral immunity.Data sources:We searched PubMed and CNKI databases using search terms“therapeutic plasma ex-change”,“ABO-incompatible liver transplantation”,“ABO-I LT”,“liver transplantation”,“LT”,“antibody-mediated rejection”,and“AMR”.Additional publications were identified by a manual search of references from key articles.The relevant publications published before September 30,2020 were included in this review.Results:Different centers have made different attempts on whether to use TPE,when to use TPE and how often to use TPE.However,the control standard of lectin revision level is always controversial,the target titer varies significantly from center to center,and the standard target titer has not yet been estab-lished.TPE has several schemes to reduce antibody titers,but there is a lack of clinical trials that provide standardized procedures.Conclusions:TPE is essential for ABO-I LT.Hence,further research and clinical trials should be conducted to determine the best regimen for TPE to remove ABO antibodies and prevent AMR.
文摘目的观察莲黄汤治疗母儿ABO血型不合的临床疗效。方法对60例母儿ABO血型不合的孕妇随机分为两组,A组采用莲黄汤加减治疗,B组采用西医治疗,随访疗效。结果两组抗体效价均有不同程度的下降,A组有效率为90.0%,B组有效率为56.7%。A组新生儿平均脐血胆红素低于B组,差异有统计学意义(P<0.01)。两组新生儿5 min Apgar评分、体重及脐血血红蛋白含量差异均无统计学意义(P>0.05)。结论莲黄汤治疗母儿ABO血型不合有较好的疗效,能有效降低其血清抗体效价,预防产后新生儿ABO溶血病的发生。
