肝移植术中RhE抗原匹配输血对患者早期预后的影响分析OA

Objective To investigate the impact of RhE antigen-matched transfusion during liver transplantation on ear-ly postoperative recovery and complications.Methods In this retrospective cohort study,ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled.Patients were divided into two groups:Group 1(RhE-mismatched transfusion,n=57)and Group 2(RhE-matched transfusion,n=38).The baseline data,complete blood counts,hepatic and renal function,coagulation parameters,and complication rates be-tween the two groups were compared at postoperative days 1,3,5,7,and 10.Survival analysis was performed using the Kaplan-Meier method.Results The baseline characteristics were well-balanced and comparable between the two groups(all P>0.05).The early postoperative mortality rate in the mismatched group(31.58%,18/57)was significantly higher than that in the matched group(10.53%,4/38)(P=0.017).The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group(50.88%,29/57)than in the matched group(10.53%,4/38)(P<0.001).The incidence of postoperative haemorrhage in the mismatched group(24.56%,14/57)was higher than that in the matched group(5.26%,2/38),with a statistically significant difference(P=0.014).The incidence of perioperative in-fection in the mismatched group(28.07%,16/57)was higher than that in the matched group(10.53%,4/38),with a statistically significant difference(P=0.04).Corresponding odds ratios(OR)and 95%confidence intervals indicated a lower risk of these adverse events in the matched group.On postoperative day 1,the change in activated partial thrombo-plastin time(-1.6,20.5)in the mismatched group was greater than in the matched group(-0.2,5.5).The change in international normalised ratio(-0.56,1.22)in the mismatched group was greater than in the matched group(-0.18,0.32),while the change in albumin(-4.0,4.8)was smaller in the mismatched group than in the matched group(-2.5,8.8).On postoperative day 5,the change in albumin(-0.41±7.83)in the mismatched group was smaller than in the matched group(2.68±4.53).At postoperative day 7,the change in albumin in the mismatched group(-0.61±7.38)was smaller than that in the matched group(2.51±5.85),while the change in D-dimer in the mismatched group(0.73,7.4)was greater than that in the matched group(-1.6,4.3).On postoperative day 10,the mismatched group exhibited signifi-cantly higher fibrinogen levels(-1.21,1.78)than the matched group(-0.49,0.97),and significantly longer prothrom-bin times(-11.3,-2.7)than the matched group(-6.2,-0.8)(all P<0.05).The matched group exhibited a mean o-verall survival(OS)of 32.803 months(95%CI:29.171-36.436 months),significantly exceeding the mismatched group's 28.996 months(95%CI:24.202-33.790 months).The log-rank test yielded statistically significant results(χ2=4.307,P=0.038).Conclusion Implementing RhE blood group-matched transfusion during liver transplan-tation may help reduce early postoperative mortality and the incidence of major complication rates,pro-mote faster recovery of coagulation and liver function,and thereby improve short-term patient outcomes.