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儿童ABO血型不合与相合肝移植疗效比较的Meta分析

田伟 李文桃 朱世凯 杨洪吉

田伟, 李文桃, 朱世凯, 等. 儿童ABO血型不合与相合肝移植疗效比较的Meta分析[J]. 器官移植, 2017, 8(6): 417-423. doi: 10.3969/j.issn.1674-7445.2017.06.002
引用本文: 田伟, 李文桃, 朱世凯, 等. 儿童ABO血型不合与相合肝移植疗效比较的Meta分析[J]. 器官移植, 2017, 8(6): 417-423. doi: 10.3969/j.issn.1674-7445.2017.06.002
Tian Wei, Li Wentao, Zhu Shikai, et al. Comparison of clinical efficacy between ABO-incompatible and ABO-compatible liver transplantation in children: a Meta-analysis[J]. ORGAN TRANSPLANTATION, 2017, 8(6): 417-423. doi: 10.3969/j.issn.1674-7445.2017.06.002
Citation: Tian Wei, Li Wentao, Zhu Shikai, et al. Comparison of clinical efficacy between ABO-incompatible and ABO-compatible liver transplantation in children: a Meta-analysis[J]. ORGAN TRANSPLANTATION, 2017, 8(6): 417-423. doi: 10.3969/j.issn.1674-7445.2017.06.002

儿童ABO血型不合与相合肝移植疗效比较的Meta分析

doi: 10.3969/j.issn.1674-7445.2017.06.002
详细信息
    通讯作者:

    杨洪吉, Email: hongji-yang65@126.com

  • 中图分类号: R617, R457.1+1

Comparison of clinical efficacy between ABO-incompatible and ABO-compatible liver transplantation in children: a Meta-analysis

More Information
  • 摘要:   目的  应用Meta分析对儿童ABO血型不合肝移植(ILT)与儿童ABO血型相合肝移植(CLT)的疗效进行比较。  方法  检索PubMed、Embase、Cochrane library、中国知网、万方、维普等国内外数据库,检索时间截至2017年5月。根据制定的纳入标准和排除标准筛选符合要求的文献,提取数据。采用Review Manager 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  共纳入11篇英文文献,均为回顾性队列研究。Meta分析结果表明ILT组受者术后1年存活率明显低于CLT组[比值比(OR)=0.64,95%可信区间(CI)0.49~0.83,P=0.0007)];ILT组术后排斥反应发生率明显高于CLT组(OR=1.96,95% CI 1.03~3.72,P=0.04);两组的术后3、10年受者存活率,术后1、3、10年移植物存活率,术后胆道并发症发生率差异无统计学意义(均为P > 0.05)。  结论  与CLT比较,ILT受者1年存活率较低而排斥反应发生率较高,但两组受者和移植物长期存活率及胆道并发症发生率相似。表明ILT是在紧急情况下挽救患者生命或长时间无法等到血型相合的肝源时较为理想的选择。

     

  • 图  1  文献筛选流程

    Figure  1.  Screening procedure of studies in Meta analysis

    图  2  儿童肝移植ILT组与CLT组受者术后1、3、10年存活率的Meta分析森林图

    A、B、C图分别为两组受者术后1、3、10年存活率

    Figure  2.  he Meta analysis forest plots of 1, 3, 10 years survival rate of pediatric liver transplant recipients between ILT group and CLT group

    图  3  儿童肝移植ILT组与CLT组移植物术后1、3、10年存活率的Meta分析森林图

    A、B、C图分别为两组移植物术后1、3、10年存活率

    Figure  3.  The Meta analysis forest plots of 1, 3, 10 years survival rate of pediatric liver transplant allograft between ILT group and CLT group

    图  4  儿童肝移植术后胆道并发症发生率的Meta分析森林图

    Figure  4.  The Meta analysis forest plots of the incidence of biliary complication after pediatric liver transplantation

    图  5  儿童肝移植术后排斥反应发生率的Meta分析森林图

    Figure  5.  The Meta analysis forest plots of the incidence of rejection after pediatric liver transplantation

    表  1  纳入11篇文献的基本情况

    Table  1.   Basic condition of 11 studies included

    究作者 年份 国家 NOS评分 ILT组 CLT组
    总例数 1、3、10年受者存活例数 1、3、10年移植物存活例数 胆道并发症发生例数 排斥反应发生例数 总例数 1、3、10年受者存活例数 1、3、10年移植物存活例数 胆道并发症发生例数 排斥反应发生例数
    Schukfeh N, et al[10] 2015 德国 7 6 5/-/- 5/-/- 0 1 40 40/-/- 33/-/- - -
    Kasahara M, et al[11] 2013 日本 8 294 239/-/220 - - - 1 930 1 724/-/1 620 - - -
    Gelas T, et al[12] 2011 英国 7 5 5/-/- 5/-/- 0 3 24 15/-/- 15/-/- 4 4
    Heffron TG, et al[13] 2010 美国 8 12 11/9/- 11/9/- - 6 21 20/20/- 20/17/- - 7
    Stewart ZA, et al[14] 2009 美国 8 246 - 164/151/132 - - 738 - 497/461/418 - -
    Ueda M, et al[15] 2006 日本 8 74 58/-/47 57/-/46 - - 494 423/-/390 421/-/337 - -
    Heffron T, et al[16] 2006 美国 7 16 16/-/- 15/-/- 2 6 122 113/-/- 102/-/- 13 47
    Varela-Fascinetto G, et al[17] 1999 美国 8 28 20/20/20 -/-/19 - - 72 48/46/44 -/-/38 - -
    Cacciarelli TV, et al[18] 1995 美国 8 14 11/11/- 10/10/- 1 11 130 109/102/- 109/102/- 7 73
    Yandza T, et al[19] 1994 美国 7 7 5/-/- 4/-/- 0 1 93 57/-/- 56/-/- 16 -
    Tokunaga Y, et al[4] 1993 美国 7 3 3/-/- 3/-/- 0 1 31 27/-/- 27/-/- 3 3
    -表示文献中未具体提及或数据难以提取
    下载: 导出CSV
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出版历程
  • 收稿日期:  2017-09-01
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2017-11-15

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