Long-term outcome and recurrence of hepatitis B virus following liver transplantation from hepatitis B surface antigen-positive donors in a Chinese population
Long-term outcome and recurrence of hepatitis B virus following liver transplantation from hepatitis B surface antigen-positive donors in a Chinese population
复制标题
DOI：
10.1111/jvh.12972
复制
发表时间：
2018-12-01
影响因子：
2.5
通讯作者：
Chen, Zhishui
中科院分区：
文献类型：
--
作者：
Wei, Lai;Chen, Dong;Chen, Zhishui
由于中国供体库严重短缺，大量患者在等待合适的肝脏，甚至更糟的是失去了移植机会。合理利用乙肝表面抗原阳性（HBsAg阳性）供体是扩大供体库的一种可行策略，但在中国人群中的长期效果尚不清楚。为评估使用HBsAg阳性供体进行肝移植的安全性，我们开展了一项多中心回顾性研究，时间跨度为2007年1月1日至2012年12月31日。在此期间，共有8632例患者接受了肝移植，其中282例（2.97%）接受了HBsAg阳性供体的肝脏。病例组和对照组各匹配了259例。两组术后肝功能障碍、早期及长期并发症的发生率，以及1年、3年和5年患者生存率（分别为78.92%对85.65%、60.41%对69.14%、58.08%对69.14%）均无差异（P值>0.05）。然而，接受HBsAg阳性供体的患者1年、3年和5年乙肝复发率高于对照组（分别为5.85%对1.97%、11.63%对4.46%、17.94%对4.46%，P值 = 0.016）。我们的研究结果表明，使用HBsAg阳性供体是可行的，术后应进行抗病毒治疗。
Due to the severe shortage of the donor pool in China, a large number of patients are waiting for a suitable liver, or even worse lose the opportunity of transplantation. Reasonable use of hepatitis B surface antigen-positive (HBsAg-positive) donors is one possible strategy to increase the donor pool but the long-term outcome in a Chinese population is unknown. To evaluate the safety of using of HBsAg-positive donor for liver transplantation, we set up a multicentric retrospective study from 1 January 2007 to 31 December 2012. A total of 8632 patients underwent liver transplantation during the period and 282 (2.97%) received a liver from a HBsAg-positive donor. A total of 259 cases in both the case and control groups were matched. The incidence of postoperative liver dysfunction, early-stage and long-term complications and the 1-, 3- and 5-year patient survival (78.92% vs 85.65%, 60.41% vs 69.14%, 58.08% vs 69.14%, respectively) showed no difference between the two groups (P value > 0.05). However, the 1-, 3- and 5-year HBV recurrence for patients received the HBsAg-positive donor was higher compared with controls (5.85% vs 1.97%, 11.63% vs 4.46%, 17.94% vs 4.46%, respectively, P value = 0.016). Our results showed the use of HBsAg-positive donors is feasible and postoperative antiviral therapy should be managed.