Abstract:

Objective To evaluate the early safety of HBcAb positive donor used on pediatric living donor liver transplant recipients. Methods We collected and registered the data of 86 pediatric living donor liver transplant recipients from July 2010 to December 2013 in Tianjin First Center Hospital. The patients were divided into HBcAb+ group and HBcAb- group according to donors' serumtest of HBcAb. The preoperative state，operation time，ICU stay time and postoperative liver function of both group were compared. Results 5 cases died among 86 pediatric living donor liver transplant recipients，and total mortality was 5.81% with 9.37% and 3.70% for HBcAb+ groupand HBcAb- group respectively without statistical difference.All pediatric recipients had no hepatitis B occurred perioperatively and there were no statistical differences of twogroups in average age and weight of recipients，preoperative PELD scores，average age and weight of donors，weight of liver graft，operation time（547.44±71.93 min vs. 546.76±95.67 min），ICU stay（119.27±50.61 hr vs. 126.61±70.78 hr）， serum value of total bilirubin，direct bilirubin，glutamic-pyruvic transaminase，glutamic-oxalacetic transaminase and international normalized ratio of 1 and 2 days before operation and post-operative day 1，3，7，14，28. （P ＞ 0.05）. Conclusion HBcAb positive liver grafts，on the basis of accurate assessment and appropriatemeasurement applied to preventhepatitisB recurrence，were safe for pediatric patients perioperativelyat least.

摘要：

目的 探讨婴幼儿活体肝移植受者接受乙肝核心抗体阳性（HBcAb+）供肝后术后早期安全性分析。方法 对天津市第一中心医院自 2010 年 7 月至 2013 年 12 月 86 例活体婴幼儿肝移植供受体的资料进行收集和登记，依据供肝 HBcAb 检测结果分为 HBcAb+ 组 32 例和 HBcAb- 组 54 例，对两组患儿术前状态、手术时间、重症监护病房（ICU）逗留时间、术后肝功能指标进行比较分析。结果 86 例亲体肝移植受者死亡 5 例，总病死率为 5.81%，HBcAb+ 组和 HBcAb- 组病死率分别为 9.37% 和 3.70%，两组病死率比较差异无统计学意义。所有患儿在围术期均无新发乙肝出现 ；两组受者平均年龄、平均体重、术前 PELD 评分，两组供者平均年龄、平均体重、供肝重量，受者手术时间（分钟 ：547.44±71.93 比 546.76±95.67）、ICU 逗留时间（小时：119.27±50.61 比 126.61±70.78）、术前 1、2 天及术后 1、3、7、14、28 天血清总胆红素（TBil）、直接胆红素（DBil）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、国际标准化比值（INR）比较差异均无统计学意义（均 P ＞ 0.05）。结论 在精准评估及采取适当措施预防乙肝复发的基础上，HBcAb+ 供肝至少在围术期对患儿是安全的。