Long-term outcome of living donor liver transplantation for primary biliary cirrhosis
Long-term outcome of living donor liver transplantation for primary biliary cirrhosis
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DOI：
10.1111/j.1432-2277.2011.01336.x
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发表时间：
2012-01-01
影响因子：
3.1
通讯作者：
Kokudo, Norihiro
中科院分区：
文献类型：
--
作者：
Kaneko, Junichi;Sugawara, Yasuhiko;Kokudo, Norihiro
在原发性胆汁性肝硬化（PBC）的活体肝移植（LDLT）中，大多数供体与其受体具有遗传相关性，这导致了对PBC早期复发和由于遗传易感性而导致的预后较差的担忧。81例接受LDLT治疗的PBC患者为本研究的受试者。免疫抑制剂包括他克莫司和甲基强的松龙。在门诊，当天冬氨酸和丙氨酸氨基转移酶水平超过正常范围的上限时，甲基强的松龙的剂量从4 mg/天增加到6 mg/天，持续数月。每2周检查一次血液，持续3个月，当转氨酶水平在超过3个月后未降至正常范围的上限时，进行肝活检。统计5年生存率和复发率，分析影响预后的因素。平均观察期为6.2年。行LDLT治疗PBC后5年，活检证实的PBC复发率为1%。患者5年生存率为80%。无关或血液相关的供体因素和人类白细胞抗原匹配的数量与预后无关。LDLT后PBC复发率低于以往研究。
In living donor liver transplantation (LDLT) for primary biliary cirrhosis (PBC), the majority of donors are genetically related to their recipients, leading to concerns of an earlier recurrence of PBC and a poorer prognosis due to genetic susceptibility. Totally 81 patients who underwent LDLT for PBC were the subjects of the present study. Immunosuppressive agents consisted of tacrolimus and methylprednisolone. In the outpatient clinic, when the aspartate and alanine aminotransferase level exceeded the upper limit of the normal range, the dose of methylprednisolone was increased from 4 to 6 mg/day for several months. Blood was examined every 2 weeks for 3 months and a liver biopsy was performed when aminotransferase levels did not decrease to the upper limit of the normal range after more than 3 months. Five-year survival and recurrence rates were estimated and the prognostic factors were analyzed. The mean observation period was 6.2 years. Five years after LDLT for PBC, the biopsy-proven PBC recurrence rate was 1%. The 5-year patient survival rate was 80%. The nonrelated or blood-related donor factor and number of human leukocyte antigen matches did not correlate with prognosis. PBC recurrence rate after LDLT in our series was lower than that in previous studies.