Living donor vs. deceased donor liver transplantation for patients with hepatitis C virus-related diseases
Living donor vs. deceased donor liver transplantation for patients with hepatitis C virus-related diseases
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活体肝移植与死者肝移植治疗丙型肝炎病毒相关疾病患者
DOI：
10.1016/j.jhep.2012.07.015
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发表时间：
2012-12-01
影响因子：
25.7
通讯作者：
He, Xiaoshun
中科院分区：
文献类型：
--
作者：
Hu, Anbin;Liang, Wenhua;He, Xiaoshun
背景和目标：活体肝移植（LDLT）为丙型肝炎病毒相关（HCV相关）疾病患者在严重器官缺乏的情况下提供了死亡供体肝移植（DDLT）的及时替代方案。然而，患者和移植物的结果，以及LDLT后HCV的复发仍然存在争议。在这里，我们试图比较移植后的结果后LDLT和DDLT.Methods：进行系统回顾和荟萃分析。检索PubMed/MEDLINE、EMBASE和科克伦数据库中的合格文献。主要终点为患者存活率、移植物存活率、复发率和急性排斥反应。采用随机效应模型计算合并比值比（OR），以综合结果。结果：共纳入14篇研究，共2024例受试者。我们发现两组患者的存活率相当（1年：OR，0.78，95% CI，0.48-1.26，p = 0.31; 2年：OR，0.71，95% CI，0.41-1.23，p = 0.23; 3年：OR，0.79，95% CI，0.5-1.12，p =0.18：4年：OR，0.92，95% CI，0.43-1.95，p = 0.83; 5年：OR，1.06，95% CI，0.53-2.14，p = 0.86）。尽管LDLT的1年和3年移植物存活率较低，但2年、4年和5年移植物存活率相似。HCV复发率和急性排斥反应率是equivalent.Conclusions：LDLT是相当于DOLT的患者生存，长期移植物存活，HCV复发，急性排斥反应率，与潜在的较低的短期患者和移植物存活。(C)2012年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: Living donor liver transplantation (LDLT) provides a timely alternative to deceased donor liver transplantation (DDLT) for patients with hepatitis C virus-related (HCV-related) diseases in the circumstances of severe organ dearth. However, the patient and graft outcomes, and recurrence of HCV after LDLT remain controversial. Here we sought to compare the post-transplant outcomes after LDLT and DDLT.Methods: A systematic review and meta-analysis were performed. PubMed/MEDLINE, EMBASE, and the Cochrane database were searched for eligible literatures. The major end points were patient survival, graft survival, recurrence rate, and acute rejection. The pooled odds ratio (OR) was calculated using random-effects model to synthesize the results. Heterogeneity and publication bias were quantitatively evaluated.Results: Fourteen studies with a total of 2024 participants were included in this analysis. We found comparable patient survival between groups (1-year: OR, 0.78, 95% Cl, 0.48-1.26, p = 0.31; 2-year: OR, 0.71, 95% Cl, 0.41-1.23, p = 0.23; 3-year: OR, 0.79, 95% CI, 0.5-1.12, p =0.18: 4-year: OR, 0.92, 95% CI, 0.43-1.95, p = 0.83; 5-year: OR, 1.06, 95% Cl, 0.53-2.14, p = 0.86, respectively). Although 1- and 3-year graft survivals were inferior in LDLT, 2-, 4- and 5-year graft survivals were similar. HCV recurrence rates and acute rejection rates were equivalent.Conclusions: LDLT was equivalent to DOLT in terms of patient survival, long-term graft survival, HCV recurrence, and acute rejection rates, with potentially lower short-term patient and graft survival. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.