Outcomes of Organ Transplantation from Donors with a Cancer History.
Outcomes of Organ Transplantation from Donors with a Cancer History.
复制标题
有癌症病史的捐献者器官移植的结果
DOI：
10.12659/msm.909059
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发表时间：
2018-02-18
期刊：
影响因子：
--
通讯作者：
He X
中科院分区：
文献类型：
--
作者：
Huang S;Tang Y;Zhu Z;Yang J;Zhang Z;Wang L;Sun C;Zhang Y;Zhao Q;Chen M;Wu L;Wang D;Ju W;Guo Z;He X
为越来越多的受者选择可接受的供体的固有挑战迫使计划承担更大的风险，包括接受有癌症史的供体（DWCH）。必须澄清使用DWCH器官进行器官移植的结果。我们评估了DWCH器官受体的移植结果。对2000年1月1日至2014年12月31日移植受体科学登记数据的回顾性分析确定了DWCH的8385例移植病例。Cox比例风险回归模型和对数秩检验用于比较各种癌症类型的患者生存率和风险水平。DWCH是患者5年生存率的独立危险因素（HR = 1.089，95% CI：1.009 - 1.176，P = 0.03）和移植物存活率（HR = 1.129，95%CI：1.056-1.208，P <0.01）（患者存活：HR = 1.112，95% CI：1.057 - 1.170，P <0.01;移植物存活：HR = 1.244，95% CI：1.052 - 1.472，P = 0.01）。两组间肾移植和肺移植无显著性差异。患有泌尿生殖系统和胃肠道癌症的供体与肾移植的不良结局相关。来自中枢神经系统癌症供体的移植导致肝移植受者的生存率更低。血液恶性肿瘤和耳鼻咽喉癌供体的器官接受者在心脏移植后的生存率较差。根据目前的供体选择标准，来自DWCH的器官的受体在肝脏和心脏移植中的结果较差，而来自DWCH的器官安全地应用于肾脏和肺移植。在进行某些类型的器官移植之前，应仔细评估特定的癌症类型。
The inherent challenges of selecting an acceptable donor for the increasing number and acuity of recipients has forced programs to take increased risks, including accepting donors with a cancer history (DWCH). Outcomes of organ transplantation using organs from DWCH must be clarified. We assessed transplant outcomes of recipients of organs from DWCH. Retrospective analysis of the Scientific Registry of Transplant Recipients data from January 1, 2000 to December 31, 2014 identified 8385 cases of transplants from DWCH. A Cox-proportional hazard regression model and log-rank test were used to compare patient survival and hazard levels of various cancer types. DWCH was an independent risk factor of 5-year patient survival (HR=1.089, 95% CI: 1.009–1.176, P=0.03) and graft survival (HR=1.129, 95% CI: 1.056–1.208, P<0.01) in liver and heart transplantation (patient survival: HR=1.112, 95% CI: 1.057–1.170, P<0.01; graft survival: HR=1.244, 95% CI: 1.052–1.472, P=0.01). There was no remarkable difference between the 2 groups in kidney and lung transplantation. Donors with genitourinary and gastrointestinal cancers were associated with inferior outcomes in kidney transplantation. Transplantation from donors with central nervous system cancer resulted in poorer survival in liver transplant recipients. Recipients of organs from donors with hematologic malignancy and otorhinolaryngologic cancer had poorer survival following heart transplantation. Under the current donor selection criteria, recipients of organs from DWCH had inferior outcomes in liver and heart transplantation, whereas organs from DWCH were safely applied in kidney and lung transplantation. Specific cancer types should be cautiously evaluated before performing certain types of organ transplantation.
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影响因子：
4
作者：
Campistol, Josep M.;Cuervas-Mons, Valentin;Ussetti, Piedad
通讯作者：
Ussetti, Piedad
影响因子：
8.8
作者：
Engels, E. A.;Castenson, D.;Kasiske, B.
通讯作者：
Kasiske, B.
影响因子：
2.9
作者：
Campbell, G. Adam;Hu, Daniel;Okusa, Mark D.
通讯作者：
Okusa, Mark D.
影响因子：
5.1
作者：
Harring, Theresa R.;O'Mahony, Christine A.;Goss, John A.
通讯作者：
Goss, John A.
影响因子：
3.1
作者：
Kamran, Sara;Conti, Filomena;Vidal-Trecan, Gwenaelle
通讯作者：
Vidal-Trecan, Gwenaelle