乙肝病毒核心抗体阳性供体活体肝移植术后安全性评价

目的 探讨活体肝移植中,乙肝表面抗原(HBsAg)阴性而乙肝病毒核心抗体(HBcAb)阳性的供体在切肝术后的安全性问题.方法 2002年3月至2006年7月我院共施行50例成人活体肝移植中,52例供体有4例HBsAg阴性而HBcAb阳性,其余供体乙肝标志物全为阴性.有2例HBsAg阴性而HBcAb阳性供体接受左半肝切除,其余50例供体均接受不包括肝中静脉的右半肝切除.比较术前HBcAb阳性和阴性两组供体肝功能指标,动态观察术后肝功能及乙肝标志物情况、残肝再生情况及其他临床指标.结果 两组供体术前肝功能指标差异无统计学意义,术后肝功能恢复、并发症发生率、残肝再生速度及住院时间差异无统计学意义;乙肝病毒标志物与术前比较两组均无变化.结论 HBsAg阴性而HBcAb阳性供体的健康成人作为活体肝移植供体是安全的.

Postoperative Safety of Liver Donors with Positive Anti-hepatitis B Core Antibodies for Adult to Adult Living Donor Liver Transplantation

Objective To evaluate the safety of liver donors with positive anti-HBc for adult to adult living- donor liver transplantation. Methods Between March 2003 and July 2005, 52 donors underwent hepatectomy for living-donor liver transplantation at the West China Hospital. Among them, four were anti-HBc-positive, 48 were anti-HBc-negative. The perioperative clinical profiles of the two groups were compared which included the Hepatitis B indicators, liver functions and growth of liver after operation. Results No significant differences were found between the two groups of donors in liver function, hepatitis B indicators, comorbidity, regeneration of remnant livers, and length of stay in hospitals. Conclusion Anti-HBc-positive donors do not have higher risks than anti-HBc-negative donors for liver transplantation.