Liver and intestine transplantation in the United States, 1997-2006
Liver and intestine transplantation in the United States, 1997-2006
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DOI：
10.1111/j.1600-6143.2008.02174.x
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发表时间：
2008-01-01
影响因子：
8.8
通讯作者：
Merion, R. M.
中科院分区：
文献类型：
--
作者：
Freeman, R. B., Jr.;Steffick, D. E.;Merion, R. M.
2006年的肝移植与前几年大致相似，等待死亡供体肝移植（DDLT）的候选人较少，延续了终末期肝病（MELD）模型实施后开始的趋势。候选人的年龄分布继续向老年人倾斜，2006年列出的儿童人数比以往任何一年都少。由于DDLT更多，活体肝移植（LDLT）略少，总移植量增加。等待名单上的死亡人数和移植时间继续改善。在2006年，MELD < 15的患者的DDLT也更少，儿科1A/B状态移植更少，心脏死亡后捐赠（DCD）捐赠者的移植更多。LDLT和DDLT的校正患者和移植物存活率相似。本文还对肝细胞癌（HCC）的移植进行了深入分析。肝细胞癌患者的移植后3年生存率低于非肝细胞癌患者。接受移植前消融治疗的HCC受者与未接受消融治疗的HCC受者相比，具有上级的移植后3年校正生存率。肠移植继续缓慢增加，等待名单上的候选人人数自1997年以来最多。存活率随着时间的推移而增加。等待肠移植的幼儿死亡率仍然是最高的。
Liver transplantation in 2006 generally resembled previous years, with fewer candidates waiting for deceased donor liver transplants (DDLT), continuing a trend initiated with the implementation of the model for end-stage liver disease (MELD). Candidate age distribution continued to skew toward older ages with fewer children listed in 2006 than in any prior year. Total transplants increased due to more DDLT with slightly fewer living donor liver transplants (LDLT). Waiting list deaths and time to transplant continued to improve. In 2006, there also were fewer DDLT for patients with MELD < 15, fewer pediatric Status 1A/B transplants and more transplants from donation after cardiac death (DCD) donors. Adjusted patient and graft survival rates were similar for LDLT and DDLT. This article also contains in-depth analyses of transplantation for hepatocellular carcinoma (HCC). Recipients with HCC had lower adjusted 3-year posttransplant survival than recipients without HCC. HCC recipients who received pretransplant ablative treatments had superior adjusted 3-year posttransplant survival compared to HCC recipients who did not. Intestinal transplantation continued to slowly increase with the largest number of candidates on the waiting list since 1997. Survival rates have increased over time. Small children waiting for intestine grafts continue to have the highest waiting list mortality.