Clinical Assessment Of ABO-incompatible Liver Transplantation

Background:Live transplantation (LT) was firstly performed in 1960s, and the technique and skill of liver transplantation were developed rapidly. Liver transplantation is becoming the most effective and important way to save patients' lives who are at the end stage of liver disease. Meanwhile, the number of patients in the waiting list are growing rapidly, liver donors are in great shortage. ABO-incompatible liver transplantation (ABO-In LT) was first performed by an expert from Japan, and the discussion of ABO-In LT is lasting. The research of survival rate and complication rate after ABO-In LT are still needed.Patents and Methods:We collected 54 liver transplantation cases from the first affiliated hospital of Zhejiang University. They were divided into 3 groups: ABO-incompatible (ABO-In) liver transplantation group, ABO-compatible (ABO-C) liver transplantation group and ABO-identical (ABO-Id) liver transplantation group. Each group had 18 cases., which were produced by random sampling method. All data were analysed by the software of SPSS 16.0. Measurement data were expressed by Mean (or Mean±SD). The comparison of the results of laboratory tests between two groups was performed by S-N-K method. The difference of survival rate was tested by life table method. We adopted chi-square test to compare the complication rate between two groups.Results:The value of ALT, AST, TB et al. was gradually decreasing, and patients got better liver function. Three months,6 months,1 year,2 year and 3 year patient survival rate in ABO-In LT group were respectively 83%,83%,71%,71%and 57%,94%,89%,89%,81%and81% in ABO-CLT group,94%,94%,94%,87% and 87% in ABO-Id LT group. When it comes to complication rate,6 patients had postoperative hemorrhage,5 patients had postoperative renal dysfunction and 5 patents had graft failure in ABO-In LT group. These 3 kinds of complication rate were much higher in ABO-In LT group. Postoperative incision problems, rejection, recurrence and infection had no obvious difference in all of the three groups.Conclusion:Patients'survival rate in ABO-In LT group was lower than that in ABO-C and ABO-Id groups. It was associated with the compatibility between donors and recipients. Postoperative hemorrhage, renal dysfunction and graft failure are main complications after ABO-In LT. Meanwhile, biliary complication and vascular complication can not be ignored. The research still had its limitation as the number of cases included in this study is relately small and the bias of sampling.