Correlation Between Autologous Blood Transfusion During Liver Transplantation For HBV-related Liver Diseases And Hepatitis B Recurrence After Liver Transplantation

Objective:Liver transplantation is the only effective means to solve the end stage liver disease,There is a contradiction between large amount of blood transfusion and Clinical blood supply tension With the increasing amount of operation.The use of retransfusion of autologous blood transfusion in the operation can relieve the situation of blood tension,but it should be concerned with the relationship between the recurrence of hepatitis B and the recurrence of HBV after operation.A prospective study was carried out on liver transplantation patients with HBV related liver disease who received autologous blood transfusion,and whether it can be safely applied to liver transplantation patients with hepatitis B related liver diseases is discussed.Methods:In this study,the clinical data of 68 patients with HBV positive in the Affiliated Hospital of Qiingdao University from November 2014 to June 2017 were selected and divided into the experimental group with autologous blood transfusion and the control group that did not use autologous blood transfusion.The data were collected and analyzed statistically.The relationship between the changes of HBV-DNA and PBMC in liver transplantation and transfusion of autologous blood was analyzed.The data collected were as follows: 1.Patients in the experimental group collected 30 min,prehepatic,anhepatic phase,peripheral venous blood after opening of the portal vein and autologous blood recovered during the operation for the quantitative determination of hepatitis B virus(HBV)DNA.2.The patients in the experimental group collected the30 min blood and intraoperative autologous blood to detect the number of monocytes and lymphocytes.At the same time,the patients were followed up after operation,including the detection of liver function,HBV-DNA,HBV surface antigen and HBV surface antibody,and the recurrence rate of HBV after operation was statistically analyzed.The correlation and risk coefficient of autologous blood transfusion and postoperative hepatitis B recurrence were analyzed based on statistical analysis.Result:1In the experimental group,there were 7 patients with incomplete follow-up data,and finally 30 patients were enrolled in the group,including 25 men and 5 women,aged from 30 to 66 years old,with an average age of 50 years and an average of 23 months(8-36).In the control group,31 patients were enrolled in the group,including 24 men and7 women,aged from 37 to 66,with average ages of 51 years,with an averagefollow-up of 22 months(6-36).There was no significant difference in gender,age,preoperative diagnosis,hepatitis B replication level,blood loss and follow-up time between the two groups.2.The experimental group were measured in the peripheral blood HBV-DNA before,before and before the liver,in the anhepatic phase and in the open period.The titer of the median HBV-DNA was 4305 iu/ml,1400 iu/ml,407.5 iu/ml and 0 iu/ml in turn.3,Pearson correlation analysis showed that the difference between hepatitis B DNA and pre hepatic HBV-DNA before operation was related to the correlation analysis of Autologous blood transfusion,P > 0.05,and no correlation.4.There were significant differences in preoperative HNV-DNA and autologous blood HNV-DNA,preoperative monocyte count,autologous mononuclear cell count,preoperative and autologous blood lymphocyte count.Conclusion:There were significant differences in HBV-DNA during the blood collected before operation,preanhepati,anhepatic phase,portal vein opening.And a downward trend in turn in order of time.It can be seen that the transfusion of autologous blood did not change the decline trend of HBV-DNA load during the operation.2.There was no correlation between the changes of HBV-DNA and the amount of autologous blood transfusion during the operation,and there was no correlation between the amount of autologous blood transfusion and the change of HBV-DNA load in the patients after liver transplantation.3.The results of the follow-up study showed that 1 patients in the control group had the recurrence of hepatitis B,the recurrence rate was 3.2%,and the recurrence rate was compared with the experimental group,P > 0.05.The results showed that the recurrence rate of hepatitis B after the infusion of autologous blood did not increase,and there was no significant difference between the group and the unused autologous blood group.However,the sample size is limited and the follow-up period is short.Further large sample studies are needed.