ABO血型不合活体肝移植术后疗效的Meta分析

目的  系统评价ABO血型不合活体肝移植（ABO-I LDLT）术后的疗效，并与ABO血型相合活体肝移植（ABO-C LDLT）相比较。方法  系统检索国内外多个数据库，收集关于ABO-I LDLT及ABO-C LDLT疗效对比的文献。根据标准筛选文献，并进行文献质量评价，提取数据。采用Rev Man 5.3软件，应用随机效应模型或固定效应模型进行Meta分析。结果  检索文献432篇，按纳入标准筛选共纳入6篇英文文献。Meta分析结果表明ABO-I LDLT组与ABO-C LDLT组的受体及移植物术后1、3、5年存活率和排斥反应发生率差异均无统计学意义（均为P≥0.05）；ABO-I LDLT组术后胆道并发症发生率和肝动脉栓塞发生率均高于ABO-C LDLT组，差异均有统计学意义[比值比（OR）=2.08，95%可信区间（CI）1.25～3.45，P=0.005；OR=2.24，95%CI 1.03～4.89，P=0.04）。结论  与ABO-C LDLT相比，ABO-I LDLT疗效稍差，但仍是一种可供选择的治疗终末期肝病的有效手段。

Clinical efficacy of ABO-incompatible living donor liver transplantation: a Meta analysis

Objective To systematically evaluate the clinical efficacy of ABO-incompatible living donor liver transplantation (ABO-I LDLT) and compare with ABO-compatible LDLT (ABO-C LDLT). Methods A systematic search of multiple databases at home and abroad was conducted to retrieve the literatures related to the statistical comparison of clinical efficacy between ABO-I LDLT and ABO-C LDLT. The literature screening was conducted, the quality of literatures was evaluated and data extraction was performed. Using Rev Man 5.3 software, a Meta-analysis was performed by random effect model or fixed effect model. Results A total of 432 articles were searched, and 6 articles published in English were eventually included according to the inclusion criteria. The Meta-analysis demonstrated that there was no significant difference in the postoperative 1-, 3- and 5-year survival rate of the recipients and grafts and the incidence of rejection responses between the ABO-I LDLT and ABO-C LDLT groups (all P≥0.05). The incidence of postoperative biliary complications and hepatic artery embolization in the ABO-I LDLT group was significantly higher than that in the ABO-C LDLT group [odds ratio (OR) =2.08, 95% confidence interval (CI) 1.25-3.45, P=0.005; OR=2.24, 95%CI 1.03-4.89, P=0.04]. Conclusions Compared with the ABO-C LDLT, ABO-I LDLT yields lower clinical efficacy, whereas it is still an effective method for the treatment of end-stage liver disease.