供受者ABO血型不合心脏移植16例临床分析

目的探讨供受者ABO血型不合心脏移植的疗效。方法回顾性分析16例供受者ABO血型不合心脏移植受者临床资料,男性12例,女性4例,采用免疫诱导和环孢素＋吗替麦考酚酯＋泼尼松三联免疫抑制方案。结果移植后受者围手术期发生急性排斥反应3例（2例经产女性受者死亡）,移植后2年发生急性排斥反应1例,感染4例。14例长期存活。未发现慢性移植物血管病。结论供受者ABO血型相容而不合的心脏移植临床疗效良好,但应慎重选择受者。

ABO mismatch in heart transplantation: analysis of 16 cases

Objective To investigate the efficacy of ABO-mismatched heart transplantation. Methods A retrospective review was undertaken on the clinical data of 16 patients, including 12 males and 4 females, undergoing ABO mismatch orthotopic heart transplantation for end-stage cardiac disease in our center. The patients received induced therapy protocols perioperatively and standard triple maintenance immunosuppressive therapy postoperatively. Results Three recipients had acute allograft rejection in the early postoperative courses and were treated with steroid-pulse therapy, and 2 of whom were multipara and died. One recipient had late acute rejection 2 years after transplantation and 4 had pulmonary infection in- cluding the above 2 deaths. The 14 survivals had a good quality of life and no episode of rejection or infection or chronic graft arteriosclerosis was observed during the tbllow-up period. Conclusion The clinical efficacy of compatible ABO-mismatch heart transplantation is acceptahle while evaluation and selection of recipients should be cautiously conducted.