中文摘要：

目的探讨联合间充质干细胞（MSC）简化方案在ABO血型不符肝移植患者中应用的安全性和可行性。方法本前瞻性研究对象为2014年1月至2015年9月在中山大学附属第三医院接受联合MSC简化方案治疗的12例ABO血型不符肝移植患者。其中男10例，女2例；平均年龄（39±13）岁。所有患者或其家属均签署知情同意书，符合医学伦理学规定。采用血浆置换±利妥昔单抗＋静脉注射免疫球蛋白＋MSC免疫耐受诱导方案（联合MSC简化方案，不包含脾切除和移植物局部灌注）预防抗体介导的排斥反应。观察患者围手术期情况及术后疗效。结果术后死亡3例，其中2例死于多器官功能衰竭，1例死于消化道出血，其余患者均存活。术后发生急性细胞性排斥反应2例，未发生抗体介导的排斥反应；胆道并发症3例，肝动脉狭窄1例，感染6例。结论联合MSC简化方案对预防ABO血型不符肝移植术后抗体介导的排斥反应是安全、有效的。

英文摘要：

Objective To investigate the safety and feasibility or a simplified protocol combining with mesenchymal stern cell （MSC） in ABO-incompatible （ABO-I） liver transplant patients. Methods Twelve ABO-I liver transplant patient who received the therapy of a simplified protocol combining with MSC in the Third Affiliated Hospital of Sun Yat-sen University between January 2014 and September 2015 were recruited in this prospective study. Ten cases were male and 2 were female, with a mean age of （39±13） years old. The informed consents of all patients or their families were obtained and the local ethical committee approval was received. A immunologic tolerance induction protocol, plasma exchange ＋ rituximab ＋ intravenous immunoglobin ＋ MSC （simplified protocol combining with MSC and without splenectomy and graft local infusion）, was used to prevent the antibody-mediated rejection （AMR） after liver transplantation （LT）. The perioperative condition and postoperative outcome of the patients were observed. Results Three death cases were observed after LT including 2 cases died of multiple organ failure and 1 of gastrointestinal hemorrhage. The other cases survived. Two cases developed acute cellular rejection and no AMR case was observed. Biliary complication was observed in 3 cases, hepatic artery stenosis in 1 case and infection in 6 cases. Conclusion The simplified protocol combining with MSC is safe and effective in preventing the AMR after ABO-I LT.