Outcome following liver transplantation for primary sclerosing cholangitis in the Nordic countries
Outcome following liver transplantation for primary sclerosing cholangitis in the Nordic countries
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DOI：
10.1080/00365520310006009
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发表时间：
2003-11-01
影响因子：
1.9
通讯作者：
Bjoro, K
中科院分区：
文献类型：
--
作者：
Brandsæter, B;Friman, S;Bjoro, K
背景：原发性硬化性胆管炎（PSC）是北欧国家最常见的肝移植指征。由于这些患者很难评估肝移植的时机，因此建立移植后生存的预测因素很重要。方法：记录1982-2001年间接受同种异体肝移植的两组患者的数据：(a) PSC患者和(b)对照患者。所有患者移植后的预后均已记录。对PSC患者进行了回归分析，以分析患者和移植物存活的预测因素。结果：从1982年到研究结束，共有245例PSC患者和618例对照患者接受了首次同种异体肝移植。PSC组和对照组的1、3、5年生存率分别为82%、77%和75%，80%、77%和74%。移植后的存活率随着时间的推移在PSC组和对照组中都有所增加。最近一年的移植，既往无肝胆手术和较低的MELD评分是PSC患者移植后生存的预测因素。PSC患者的再移植率更高（13%比8%，P = 0.01）。PSC患者再次移植的预测因素是早期排斥反应和血管血栓形成。结论：在PSC患者中，移植年份、既往肝胆手术和MELD评分是移植后生存的预测指标，与对照组相比，这些患者需要再次移植的频率更高。
Background: Primary sclerosing cholangitis (PSC) is the most common indication for liver transplantation in the Nordic countries. Because these patients are difficult to evaluate with regard to timing of liver transplantation, it is important to establish predictors of post-transplant survival. Methods: Data from two groups of patients receiving liver allografts during 1982-2001 were recorded: (a) PSC patients and (b) comparison patients. Outcome following transplantation has been recorded for all patients. Regression analyses have been performed for PSC patients to analyse predictors of patient and graft survival. Results: A total of 245 PSC and 618 comparison patients received a first liver allograft in the period 1982 until the end of the study. The overall 1-, 3- and 5-year patient survival rates were 82%, 77% and 75%, and 80%, 77% and 74% in the PSC group and comparison group, respectively. Survival following transplantation has increased with time in both the PSC and the comparison group. Recent year of transplantation, no previous hepatobiliary surgery and a lower MELD score were predictors of survival following transplantation for PSC patients. PSC patients had a higher rate of re-transplantations (13% versus 8%, P = 0.01). Predictors of re-transplantation in PSC patients were an episode of early rejection and vascular thrombosis. Conclusion: In PSC patients, year of transplantation, previous hepatobiliary surgery and MELD score are predictors of survival following transplantation and these patients are more frequently in need of re-transplantation compared to the comparison group.