Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect.
Impact of Recipient and Donor Obesity Match on the Outcomes of Liver Transplantation: All Matches Are Not Perfect.
复制标题
受者和供者肥胖匹配对肝移植结果的影响：并非所有匹配都是完美的。
DOI：
10.1155/2016/9709430
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发表时间：
2016
影响因子：
2.5
通讯作者：
Mumtaz,Khalid
中科院分区：
文献类型：
--
作者：
Beal,ElizaW;Tumin,Dmitry;Conteh,LanlaF;Hanje,AJames;Michaels,AnthonyJ;HayesJr,Don;Black,SylvesterM;Mumtaz,Khalid
关于受体-供体肥胖匹配对肝移植结局影响的文献很少。在器官共享联合网络数据库中查询了2003年1月至2013年9月期间年龄≥18岁的首次肝移植受者。比较接受非肥胖供体移植的非肥胖受体与肥胖受体-肥胖供体、肥胖受体-非肥胖供体和非肥胖受体-肥胖供体对的结局，包括30天、1年和5年的患者和移植物存活率以及总体存活率、再次肝移植和住院时间。确定了51，556名LT接受者，包括34，217名（66%）非肥胖接受者和17，339名（34%）肥胖接受者。在非肥胖和肥胖受者中，接受肥胖供体同种异体移植的患者比例分别为24%和29%。移植物丢失（HR：1.27; 95%可信区间：在肥胖受体-肥胖供体配对中，30天时的死亡率（HR：1.38; 95% CI：1.16-1.65;p< 0.001）增加。然而，1年移植物（HR：0.83; 95% CI：0.74-0.93;p= 0.002）和患者（HR：0.84; 95% CI：0.74-0.95;p= 0.007）生存率以及总体患者（HR：0.93; 95% CI：0.86-1.00;p= 0.042）生存率有利。有证据表明受体和供体肥胖在早期处于不利地位，但生存曲线显示长期结局改善。重要的是要考虑到肥胖的供体-受体匹配。
There is a paucity of literature examining recipient‐donor obesity matching on liver transplantation outcomes. The United Network for Organ Sharing database was queried for first‐time recipients of liver transplant whose age was ≥18 between January 2003 and September 2013. Outcomes including patient and graft survival at 30 days, 1 year, and 5 years and overall, liver retransplantation, and length of stay were compared between nonobese recipients receiving a graft from nonobese donors and obese recipient‐obese donor, obese recipient‐nonobese donor, and nonobese recipient‐obese donor pairs. 51,556 LT recipients were identified, including 34,217 (66%) nonobese and 17,339 (34%) obese recipients. The proportions of patients receiving an allograft from an obese donor were 24% and 29%, respectively, among nonobese and obese recipients. Graft loss (HR: 1.27; 95% CI: 1.09–1.46;p= 0.002) and mortality (HR: 1.38; 95% CI: 1.16–1.65;p< 0.001) at 30 days were increased in the obese recipient‐obese donor pair. However, 1‐year graft (HR: 0.83; 95% CI: 0.74–0.93;p= 0.002) and patient (HR: 0.84; 95% CI: 0.74–0.95;p= 0.007) survival and overall patient (HR: 0.93; 95% CI: 0.86–1.00;p= 0.042) survival were favorable. There is evidence of recipient and donor obesity disadvantage early, but survival curves demonstrate improved long‐term outcomes. It is important to consider obesity in the donor‐recipient match.