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Objective To explore the safety of liver transplantation recipients with Rh blood group mismatchming .Methods From May 2005 to December 2018 ,1546 cases of liver transplantation in our hospital were retrospectively analyzed . Among these cases ,5 cases of Rh blood group mismatched were Rh(-) recipients receiving Rh(+ ) donor liver .For each Rh blood group mismatched liver transplantation ,5 patients received the same Rh blood group liver allograft were matched according to a certain principle and were defined as Rh-mismatch group and Rh-match group respectively .The serum alanine aminotransferase (ALT ) ,aspartate aminotransferase (AST ) and creatinine(SCr)were compared between two groups at Days 7 & 14 post-operation .Serum total bilirubin(TB) ,gamma-glutamyl transpeptidase(GGT)were compared between two groups at Month 1 , 6 & 12 post-operation .Hemoglobin (Hb)were compared between two groups Month 1 ,3 & 6 post-operation . The rates of infection ,vascular complications and acute rejection was also compared . Indirect antiglobulin test (IAT)was used for detecting the production of anti-RhD antibody in patients in Rh-mismatch group at Month 1 ,6 & 12 post-operation .Results At the mentioned time ,no significant inter-group difference existed in serum ALT ,AST ,SCr ,TB ,GGT and blood Hb levels (all P>0 .05);Also ,no significant difference existed in the incidence of infection ,vascular complications or acute rejection(all P> 0 .05) .In Rhmismatch group ,4 recipients received Rh (+ )RBC transfusion during perioperative period and no hemolytic anemia occurred after operation .Rh(D) antibody was negative at all timepoints .Conclusions Taking into account the rarity of Rh-negative blood group in Chinese ,it is safe and feasible to carry out Rh blood group mismatched liver transplantation when donor or recipient with the same Rh blood group is not available .
RÉSUMÉ
Objective@#To explore the safety of liver transplantation recipients with Rh blood group mismatchming.@*Methods@#From May 2005 to December 2018, 1 546 cases of liver transplantation in our hospital were retrospectively analyzed. Among these cases, 5 cases of Rh blood group mismatched were Rh(-) recipients receiving Rh(+ ) donor liver. For each Rh blood group mismatched liver transplantation, 5 patients received the same Rh blood group liver allograft were matched according to a certain principle and were defined as Rh-mismatch group and Rh-match group respectively. The serum alanine aminotransferase (ALT), aspartate aminotransferase(AST)and creatinine(SCr)were compared between two groups at Days 7 & 14 post-operation. Serum total bilirubin(TB), gamma-glutamyl transpeptidase(GGT)were compared between two groups at Month 1, 6 & 12 post-operation. Hemoglobin (Hb)were compared between two groups Month 1, 3 & 6 post-operation. The rates of infection, vascular complications and acute rejection was also compared. Indirect antiglobulin test (IAT)was used for detecting the production of anti-RhD antibody in patients in Rh-mismatch group at Month 1, 6 & 12 post-operation.@*Results@#At the mentioned time, no significant inter-group difference existed in serum ALT, AST, SCr, TB, GGT and blood Hb levels(all P>0.05); Also, no significant difference existed in the incidence of infection, vascular complications or acute rejection(all P>0.05). In Rhmismatch group, 4 recipients received Rh(+ )RBC transfusion during perioperative period and no hemolytic anemia occurred after operation. Rh(D) antibody was negative at all timepoints.@*Conclusions@#Taking into account the rarity of Rh-negative blood group in Chinese, it is safe and feasible to carry out Rh blood group mismatched liver transplantation when donor or recipient with the same Rh blood group is not available.
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Objective To summarize our experience in the diagnosis and treatment of hepatic epithelioid angiomyolipoma (HEAML),with the aim to reduce the future misdiagnosis rate.Methods The PubMed,Medline,China Science Periodical Database (CSPD),and VIP Databases were searched from January 2000 to March 2018 on all reports on HEAML.Results There were 409 cases of HEAML in 97 reports.The ratio of men to women was 1∶4.84.The age ranged from 12 to 80 years and the median age was 44 years.61.9％ of patients (205/331) were asymptomatic,while 34.7％ (115/331) had upper or right upper quadrant abdominal discomfort.Some patients presented with abdominal mass,gastrointestinal reaction,low grade fever or weight loss.The clinical symptoms in 78 patients were not mentioned in the reports.The misdiagnostic rate of HEAML was as high as 40.3％ (165/409).The imaging findings of HEAML were nonspecific.Ultrasound,CT and MRI scan usually showed contrast enhancement in the arterial phase.Most lesions were accompanied by central vessels with early drainage veins.The enhanced scans showed varied characteristics.The ratios of fast wash-in and fast wash-out,to fast wash-in and slow wash-out,and to delayed enhancement were roughly 4∶ 5∶ 1.A definitive diagnosis of HEAML is based on the pathological findings of epithelioid cells in the lesions and the expressions of HMB45,SMA,Melan-A and Actin on immunohistochemical staining.HEAML had a relatively low malignant rate of 3.9％.Surgical resection was the main treatment for HEAML.Conclusion HEAML was a rare and easily misdiagnosed disease.,which could be diagnosed by taking into account the clinical course,imaging,pathological and immunohistochemical findings.HEAML.