ABO血型不合肝移植疗效的Meta分析

目的  系统评价ABO血型不合肝移植(ILT)的治疗效果，并与ABO血型相合肝移植(CLT)的疗效进行比较。方法  通过计算机检索PubMed数据库、Embase数据库、Cochrane数据库、Medline数据库、Web of science数据库、中国知网、万方数据库、维普数据库等国内外数据库，收集国内外关于ILT及CLT临床疗效对比的文献，对文献质量进行评估。采用RevMan5.3软件，利用固定效应模型及随机效应模型进行Meta分析。结果  共纳入18篇文献。Meta分析结果表明ILT组与CLT组受者术后1、3、5年存活率差异无统计学意义(均为P＞0.05)；与CLT组相比，ILT组移植物1、3、5年存活率明显降低，差异有统计学意义(均为P＜0.05)；ILT组术后胆道并发症和急性排斥反应发生率明显高于CLT组，差异有统计学意义(均为P＜0.05)。结论  与CLT相比，ILT疗效稍逊，但仍可作为受体病情危急情况下或等待供肝时间过长时的新选择。

Meta analysis of therapeutic effects on patients with ABO-incompatibility liver transplantation

Objective To systematic evaluation the therapeutic effects on patients with ABO-incompatibility liver transplantation (ILT), and compare the curative effect with ABO-compatible liver transplantation (CLT). Methods The literatures of comparison in clinical efficacy between ILT and CLT were collected at home and abroad by computer search in PubMed database, Embase database, Cochrane database, Medline database, Web of science database, CNKI, Wanfang database, VIP database, et al, and the quality of literatures were accessed. Meta analysis was carried out by fixed effect model and random effect model with RevMan5.3 software. Results A total of 18 papers were included. The results of Meta analysis showed that there was no significant difference in the survival rates of recipient between ILT group and CLT group at 1, 3 and 5 years after operation (all P > 0.05). Compared with CLT group, the survival rates of grafts were significantly decreased in ILT group at 1, 3 and 5 years after operation, and the difference was statistically significant (all P < 0.05). The incidences of postoperative biliary complication and acute rejection in ILT group were significantly higher than those in CLT group, the difference was statistically significant (both P < 0.05). Conclusions Compared with CLT, the curative effect of ILT is weaker but still can be used as a new choice for critical condition of the recipient or waiting for the donor liver for a long time.