Liver Transplantation in the United States, 1999-2008
Liver Transplantation in the United States, 1999-2008
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DOI：
10.1111/j.1600-6143.2010.03037.x
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发表时间：
2010-01-01
影响因子：
8.8
通讯作者：
Pelletier, S. J.
中科院分区：
文献类型：
--
作者：
Thuluvath, P. J.;Guidinger, M. K.;Pelletier, S. J.
2002年器官分配政策的变化减少了肝移植等候名单上的成年患者数量，改变了移植受者的特征，增加了接受肝肾联合移植（SLK）的患者数量。肝移植数量在2006年达到顶峰，2007年和2008年略有下降。在此期间，供体年龄、供体风险指数、接受MELD异常评分的候选人数量和肝细胞癌接受者数量均有所增加。相反，再次移植率和接受活体供体或心脏死亡后捐赠的移植物的患者数量有所下降。在此期间，严重肥胖、糖尿病和肾功能不全的患者比例增加。尽管供体和受体的风险因素增加，但1998年至2007年期间移植物和患者的1年生存率有提高的趋势。然而，主要关注的是等待时间和移植后存活率的相当大的区域差异。使用SRTR数据分析了1999年至2008年美国肝移植的现状。除了一般性的总结，我们还包括了对丙型肝炎肝移植、再次移植和SLK移植的更详细的分析。
Changes in organ allocation policy in 2002 reduced the number of adult patients on the liver transplant waiting list, changed the characteristics of transplant recipients and increased the number of patients receiving simultaneous liver-kidney transplantation (SLK). The number of liver transplants peaked in 2006 and declined marginally in 2007 and 2008. During this period, there was an increase in donor age, the Donor Risk Index, the number of candidates receiving MELD exception scores and the number of recipients with hepatocellular carcinoma. In contrast, there was a decrease in retransplantation rates, and the number of patients receiving grafts from either a living donor or from donation after cardiac death. The proportion of patients with severe obesity, diabetes and renal insufficiency increased during this period. Despite increases in donor and recipient risk factors, there was a trend towards better 1-year graft and patient survival between 1998 and 2007. Of major concern, however, were considerable regional variations in waiting time and posttransplant survival. The current status of liver transplantation in the United States between 1999 and 2008 was analyzed using SRTR data. In addition to a general summary, we have included a more detailed analysis of liver transplantation for hepatitis C, retransplantation and SLK transplantation.