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ABO血型不相容肾移植(ABO incompatible kidney transplantation,ABOi-KT)由于可发生超急性排斥反应和血型障碍,一直被认为是终末期肾病的绝对禁忌证。自从报道第1例成功的ABOi-KT以来,世界上施行ABOi-KT的患者逐渐增多。ABOi-KT的开展,扩大了器官捐助池,减少了终末期肾病患者等待捐献的时间。相比10年前,ABOi-KT治疗方案获得了很大的进步和简化,尤其在近几年,ABOi-KT的效果堪比ABO血型相容肾移植(ABO compatible kidney transplantation,ABOc-KT)。然而,许多问题仍然没有答案,故本文就ABOi-KT的发展过程、治疗方案、优缺点,以及发展前景做一综述。
ABO incompatible kidney transplantation (ABOi-KT) has been considered the absolute contraindication of end-stage renal disease due to hyperacute rejection and blood group disorder. Since the first case of ABOi-KT was reported, there has been an increase in the number of ABOi-KT patients in the world. The implementation of ABOi-KT has expanded the donor pool and reduced the waiting time for end-stage renal disease patients to donate. The ABOi-KT regimen has been greatly improved and simplified over the past decade, especially since ABOi-KT has been shown to perform as ABO-compatible kidney transplantation (ABOc-KT) in recent years. However, many questions still have no answer, so this article reviews the development process, treatment plan, advantages and disadvantages, and development prospects of ABOi-KT.