Outcomes of Liver Transplantation Using Pediatric Deceased Donor Livers: A Single-Center Analysis of 102 Donors
Outcomes of Liver Transplantation Using Pediatric Deceased Donor Livers: A Single-Center Analysis of 102 Donors
复制标题
使用儿童死亡供体肝脏进行肝移植的结果：对 102 名供体的单中心分析
作者：
Rui Zhang;Zhi;Liying Sun;Lin Wei;W. Qu
背景：儿童已故供体肝移植(LT)的结果尚未得到很好的研究，尤其是用于成人移植的儿童已故供体肝脏。本研究旨在评价儿童已故供体肝移植的疗效，并比较儿童至儿童供肝和儿童至成人供肝的移植效果。方法：对2013年6月至2016年8月间采用儿童已故供体肝脏进行的肝移植进行了回顾性研究。根据受者的年龄将患者分为儿童至儿童移植组和儿童至成人移植组。观察两组患者的存活率和早期血管并发症(VCs)发生率。我们还分析了儿童肝移植早期VC的危险因素及供体高钠血症对受体预后的影响。结果：自2013年6月至2016年8月，本院共收治儿童已故供肝移植102例，其中83例(受者年龄⩽13岁)，19例(受者年龄≥19岁)。早期VC发生率两组相似(19.3%vs.10.6%，P=0.514)。低体重是儿童移植术后早期VC的独立危险因素(优势比：0.856，95%可信区间：0.752~0.975，P=0.019)。移植肾和患者的1年累积存活率分别为89.16%和91.57%，89.47%和94.74%(均P>；0.05)。在所有病例中，使用高钠血症(血钠水平≥为150mmoL/L)的患者移植肾存活率较差(2=4.330，P=0.037)。结论：儿童到儿童肝移植组的移植物和患者存活率与儿童到成人肝移植组相似。低体重是儿童肝移植早期VC的独立危险因素。使用高钠血症供者的患者移植物存活率较差。
Background: The outcome of pediatric deceased donor liver transplantation (LT) has not been well studied, especially pediatric deceased donor livers used in adult transplantation. This study aimed to evaluate the efficacy of LT using pediatric deceased donor livers and compare the outcomes between pediatric-to-pediatric LT and pediatric-to-adult LT. Methods: A retrospective review of LT using pediatric deceased donor livers from June 2013 to August 2016 was performed. The patients were divided into the pediatric-to-pediatric LT group and pediatric-to-adult LT group based on the ages of the recipients. The survival and incidence of early vascular complications (VCs) were observed between the two groups. We also analyzed the risk factors of early VCs in pediatric LT and the effect of donor hypernatremia on the prognosis of recipients. Results: There were 102 cases of LT using pediatric deceased donor livers in our hospital from June 2013 to August 2016, 83 pediatric-to-pediatric LT (recipients’ age ⩽13 years) and 19 pediatric-to-adult LT (recipients’ age ≥19 years). The ratio of early VC was similar in the two groups (19.3% vs. 10.6%, P = 0.514). Low body weight of recipient was an independent risk factor of early VC in pediatric LT (odds ratio: 0.856, 95% confidence interval: 0.752–0.975, P = 0.019). The 1-year cumulative survival rates of grafts and patients were 89.16% and 91.57% in pediatric-to-pediatric LT and 89.47% and 94.74% in pediatric-to-adult LT, respectively (all P > 0.05). In all cases, patients using donors with hypernatremia (serum sodium levels ≥150 mmol/L) had worse graft survival (&khgr;2=4.330, P = 0.037). Conclusions: Pediatric-to-pediatric LT group has similar graft and patient survival rates with those of pediatric-to-adult LT group. Low body weight of recipients is an independent risk factor of early VC in pediatric LT. Patients using donors with hypernatremia have worse graft survival.
影响因子：
25.7
作者：
Dhillon, Navdeep;Walsh, Liron;Schroeppel, Bernd
通讯作者：
Schroeppel, Bernd