OPTN/SRTR 2018 Annual Data Report: Liver
OPTN/SRTR 2018 Annual Data Report: Liver
复制标题
DOI：
10.1111/ajt.15674
复制
发表时间：
2020-01-01
影响因子：
8.8
通讯作者：
Kasiske, B. L.
中科院分区：
文献类型：
--
作者：
Kwong, A.;Kim, W. R.;Kasiske, B. L.
2018年在美国进行的成人肝移植数据值得注意的是：（1）新等待名单登记人数（11，844）和移植人数（8250）的持续增长;（2）移植率的持续增加（54.5/100等待名单年）;（3）丙型肝炎相关适应症的等待名单登记和移植急剧下降;（4）酒精性肝病和非酒精性脂肪性肝病临床特征一致的等待名单登记者和接受者增加;（5）丙型肝炎病毒抗体阳性供体肝脏的使用增加;和（6）尽管受者的特征发生了变化，如年龄增大、肥胖和糖尿病的发生率增高，但移植物存活率持续提高。移植率的变异性仍然与候选种族、肝细胞癌状态、紧急状态和地理位置有关。小儿肝移植的体积相对不变。移植前死亡率最高的是1岁以下的儿童。与过去相比，儿童以更高的敏锐度接受移植，这可以通过移植时终末期肝病/儿科终末期肝病评分的更高模型和1A和1B状态列表来证明。尽管移植时疾病严重程度评分较高，但随着时间的推移，儿科移植物和移植后患者的生存率有所改善。
Data on adult liver transplants performed in the US in 2018 are notable for (1) continued growth in numbers of new waitlist registrants (11,844) and transplants performed (8250); (2) continued increase in the transplant rate (54.5 per 100 waitlist-years); (3) a precipitous decline in waitlist registrations and transplants for hepatitis-C-related indications; (4) increases in waitlist registrants and recipients with alcoholic liver disease and with clinical profiles consistent with non-alcoholic fatty liver disease; (5) increased use of hepatitis C virus antibody-positive donor livers; and (6) continued improvement in graft survival despite changing recipient characteristics such as older age and higher rates of obesity and diabetes. Variability in transplant rates remained by candidate race, hepatocellular carcinoma status, urgency status, and geography. The volume of pediatric liver transplants was relatively unchanged. The highest rate of pre-transplant mortality persisted for children aged younger than 1 year. Children underwent transplant at higher acuity than in the past, as evidenced by higher model for end-stage liver disease/pediatric end-stage liver disease scores and listings at status 1A and 1B at transplant. Despite higher illness severity scores at transplant, pediatric graft and patient survival posttransplant have improved over time.