ABO incompatible(ABO-I) liver grafts will affect the prognosis of liver transplantation. With the improvement of perioperative treatment,including plasma exchange,rituximab,splenectomy,etc.,the prognosis of ABO-I liver transplantation has been greatly improved. Because children's immune systems are not fully developed,the perioperative management of ABO-I pediatric liver transplantation is significantly different from that of adults. Reducing the perioperative anti-donor ABO antibody titer is the key to the perioperative management of ABO-I liver transplantation. This article summarizes literatures on the perioperative management of ABO-I pediatric liver transplantation, including the perioperative anti-rejection regimen in pediatric recipients of different ages, splenectomy, postoperative monitoring and postoperative complications, etc.
ABO血型不相容(ABO-I)供肝是影响肝移植预后的重要因素。随着血浆置换、利妥昔单抗、脾切除术等围手术期治疗手段的应用,ABO-I肝移植的预后已得到了很大改善。由于儿童的免疫系统发育不完善,儿童ABO-I肝移植围手术期的处理方案与成人有明显不同。降低围手术期抗供者的血型抗体水平是儿童ABO-I 肝移植围手术期处理的关键。本文综合国内外的文献,就儿童ABO-I 肝移植中针对不同年龄段儿童受体的围手术期抗排斥治疗方案、是否行脾脏切除术、术后监测方式及术后常见并发症等围手术期治疗处理进行综述。.