目的 探讨双重血浆置换在ABO 血型不合肝移植中的治疗效果。方法 20例ABO血型不合的肝移植患者,随机分为双重血浆置换组(治疗组)和对照组,观察两组治疗3周后临床症状、并发症发生情况、肝功能生化指标的变化等,随访治疗后3个月内病情转归情况并分析影响疗效的因素。结果 经过双重血浆置换治疗24 h后,5例患者受体术前血型抗体滴度为1∶32,术后24 h内稳定在1∶8;3例患者受体术前血型抗体滴度为1∶4, 术后7 d内稳定在1∶2;2例患者受体术前1∶16,术后2～3个月开始反弹后又自行下降并稳定在1∶8。根据整体疗效而言,治疗组有效率达80.0%,对照组有效率为40.0%,治疗组明显高于对照组(P<0.05)。结论 双重血浆置换是一种治疗血型不合肝移植有效、可靠的技术手段,使得术后患者的生存质量得到改善。

Objective To investigate the therapeutic effect of double plasma exchange in the treatment of ABO incompatible liver transplantation. Methods The clinical data of 20 cases of ABO incompatible liver transplantation in this hospital were retrospectively analyzed were observed in double plasma exchange group and control group after 3 weeks of treatment. Illness prognosis was followed up after treatment for 3 months and influencing factors were analyzed. Results According to the laboratory test, after double plasma exchange treatment for 24 hours, 5 patients with receptor preoperative blood group antibody titer of 1∶32 showed stability in 1∶8 within 24 hours after the operation; 3 patients with receptor preoperative blood group antibody titer of 1∶4 showed: stablitg in 1∶2 within 7 days after the operation; 2 patients with reseptor of 1∶16, began to rebound after 2-3 months and then decreased and stabliized in 1∶8. According to the overall effect, in the treatment group of 10 patients, 8 cases were effective, an effective rate of 80%. In the control group, 10 cases (4) were effective, 5 cases (40%), 1 cases (10%) were discharged. The efficacy in the treatment group was significantly higher than that in the control group (P<0.05). Conclusions Double plasma exchange is an effective and reliable technique for the treatment of different liver transplantation, which can improve the survival time of patients.