针对RBC抗原的同种异体免疫与肝移植受者的存活率降低无关
Alloimmunization Against RBC Antigens Is Not Associated With Decreased Survival in Liver Transplant Recipients
影响因子:1.90000
分区:医学4区 / 病理学3区
发表日期:2023 Mar 13
作者:
Yevgen Chornenkyy, Alcino Pires Gama, Christopher Felicelli, Nigar Khurram, Adam L Booth, Joseph R Leventhal, Glenn Eugene Ramsey, Guang-Yu Yang
摘要
肝移植（LT）结局的改善需要更好地理解影响生存的因素。评估了RBC同种抗体（RBCA）在LT接受者中的生存中的存在。这项研究是一项单中心回顾性的同类研究研究，审查了2002年至2021年之间的输血记录和全因死亡率。2002年至2021年之间的全因死亡率。 [6.5％]）。同龄人的年龄相似（平均[范围]，55.8 [17-79]年，vs 56.8 [25-73]年； p = .41）或性别（RBCA负面，859 [65％]男性和446 [35％] [35％]女性vs rbca and vs rbca agith，51 [56％]男性和40 [44％]女性；在检测到的132个RBCA中，最常见的是E（27.27％），JKA（15.91％），K（9.09％），C（8.33％），M（6.06％），D（5.3％），FYA（4.55％），E（4.55％），E（2.27％），C（2.27％），C（2.27％）和JKB（2.27％）和2.27％（2.27％）。 27例患者（29.7％）的患者超过1卢比；最常见的组合是与JKA（7.4％）和DIA（7.4％）的C。男性（男性，14.45岁与女性，17.27岁； p = .0266）和65岁以上的患者（≥65岁，10岁，10.21岁，10.21岁，<64岁，17.22岁； p <.0001）。 rbca（≥1）的存在不会影响全因死亡率（RBCA负数，14。17年，而RBCA正面为15。29年； p = .4367）。死亡的前5名原因是感染（11.9％），原发性恶性肿瘤（固体）（10.8％），复发性恶性肿瘤（10.5％），心血管骤停（7.1％）和肺部不足/呼吸衰竭（5.7％）。在RBCA阳性LT中的生存与RBCA-NECTERIENT在RBCA-RBCA-NECHENDENS中没有不同。
Abstract
Improvement of liver transplantation (LT) outcomes requires better understanding of factors affecting survival. The presence of RBC alloantibodies (RBCAs) on survival in LT recipients was evaluated.This study was a single-center, retrospective cohort study reviewing transfusion records and all-cause mortality between 2002 and 2021.Between 2002 and 2021, 2079 LTs were completed, 1,396 of which met inclusion criteria (1,305 RBCA negative; 91 RBCA positive [6.5%]). The cohorts were similar in age (mean [range], 55.8 [17-79] years vs 56.8 [25-73] years; P = .41, respectively) or sex (RBCA negative, 859 [65%] men and 446 [35%] women vs RBCA positive, 51 [56%] men and 40 [44%] women; P = .0684). Of 132 RBCAs detected, 10 were most common were to E (27.27%), Jka (15.91%), K (9.09%), C (8.33%), M (6.06%), D (5.3%), Fya (4.55%), e (2.27%), c (2.27%), and Jkb (2.27%). Twenty-seven patients (29.7%) had more than 1 RBCA; the most common combinations were C with Jka (7.4%) and E with Dia (7.4%). All-cause mortality was increased in men (men, 14.45 years vs women, 17.27 years; P = .0266) and patients 65 years of age and older (≥65 years of age, 10.21 years vs <64 years of age, 17.22 years; P < .0001). The presence of RBCA (≥1) did not affect all-cause mortality (RBCA negative, 14.17 years vs RBCA positive, 15.29 years; P = .4367). The top 5 causes of death were infection (11.9%), primary malignancy (solid) (10.8%), recurrent malignancy (10.5%), cardiovascular arrest (7.1%), and pulmonary insufficiency/respiratory failure (5.7%).Survival in RBCA-positive LT recipients is no different from that in RBCA-negative LT recipients.