Graft-versus-host disease after orthotopic liver transplantation: multivariate analysis of risk factors
Graft-versus-host disease after orthotopic liver transplantation: multivariate analysis of risk factors
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DOI：
10.1111/ctr.12627
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发表时间：
2015-12-01
影响因子：
2.1
通讯作者：
Harnois, Denise M.
中科院分区：
文献类型：
--
作者：
Elfeki, Mohamed A.;Pungpapong, Surakit;Harnois, Denise M.
移植物抗宿主病（GVHD）是原位肝移植（OLT）后罕见的致命并发症。迄今为止，已经提出了几个风险因素，但关于这些因素的报告尚无定论。这是一项回顾性的病例对照研究，前瞻性地收集了在我院进行的2775例olt的数据。根据患者的临床特征诊断出8例OLT后GVHD，并通过皮肤和结肠活检证实。根据肝脏疾病的诊断、接受者的年龄和血型，每个病例都与三个对照组相匹配。进行单因素和多因素分析，以确定与OLT后GVHD发展相关的危险因素。单变量和多变量分析确定了与OLT受者GVHD发展相关的两个主要危险因素，受者和供者年龄之间的差异为100 - 20岁，以及任何人类白细胞抗原I类匹配。在匹配潜在供体和受体时考虑这两个风险因素可能会进一步降低OLT患者GVHD的发病率。然而，建议进一步的研究来验证这些发现。
Graft-versus-host disease (GVHD) is a rare, fatal complication following orthotopic liver transplantation (OLT). To date, several risk factors have been proposed, but reports on these factors have been inconclusive. This is a retrospective, case-control study of prospectively collected data from 2775 OLTs performed at our institution. Eight cases of GVHD after OLT were diagnosed on the basis of the patient's clinical characteristics, and the findings were confirmed with skin and colonic biopsies. Each case was matched to three controls based on the diagnosis of liver disease, recipient's age, and blood group. Univariate and multivariate analyses were performed to identify risk factors associated with the development of GVHD after OLT. The univariate and multivariate analyses identified two main risk factors associated with development of GVHD in OLT recipients, a difference between recipient and donor age of >20 yr, and any human leukocyte antigen class I matches. Taking these two risk factors into consideration while matching prospective donors and recipients may reduce further incidence of GVHD in OLT patients. However, further studies are recommended to validate these findings.