Heavy Alcohol Use Among Deceased Donors Does Not Impact Recipient Outcomes After Liver Transplantation
Heavy Alcohol Use Among Deceased Donors Does Not Impact Recipient Outcomes After Liver Transplantation
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DOI：
10.1097/tp.0000000000002230
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发表时间：
2018-11-01
期刊：
影响因子：
6.2
通讯作者：
Singal, Ashwani K.
中科院分区：
文献类型：
--
作者：
Arora, Sumant S.;Chahal, Khushdeep S.;Singal, Ashwani K.
使用大量饮酒（HD）的已故供体进行肝移植（LT）结局的背景数据方法利用器官共享联合网络数据库（2002-2014年），我们比较了已故HD供体和非HD（ND）供体的成人LT结果，结果在美国进行的56182例首次LT中，有47882例使用已故供体进行了酒精使用的可用信息。在这47882例LT接受者中，7298例（15%）来自HD供体，随着时间的推移（2002-2014年，Armitage趋势检验P = 0.75）和接受者肝病病因（P-2 = 0.42）的比例相似。HD供体用于LT的肝器官比例低于ND供体（63% vs 78%; P < 0.001）。比较7166例HD供体和21498例ND供体（基于倾向评分匹配）的首次LT的5年结局，肝移植（73.7% vs 73.7%，对数秩P = 0.98）和患者生存率（77.6% vs 77.0%，P = 0.36）相似。在考克斯回归分析中，死亡供体的HD史不影响肝移植1.02（0.97-1.08）或患者存活1.03（0.97-1.09）。结论在使用选择的肝移植的LT受体中，死亡供体的HD史不影响LT后的结果。
Background Data on liver transplant (LT) outcomes using deceased donors with heavy drinking (HD) (>2 drinks per day) are scanty.Methods Using the United Network for Organ Sharing database (2002-2014), we examined outcomes after LT in adults comparing deceased HD donors with non-HD (ND) donors.Results Of 56 182 first LTs performed in the United States for 10 common indications using deceased donors, 47 882 with available information on alcohol use were analyzed. Of these 47 882 LT recipients, 7298 (15%) were from HD donors, with similar proportion over time (2002-2014, Armitage trend test P = 0.75) and for recipient liver disease etiology (P-2 = 0.42). Proportion of liver organ used for LT was lower for HD donors compared with ND donors (63% vs 78%; P < 0.001). Five-year outcomes on first LT comparing 7166 HD donors and 21 498 ND donors matched based on propensity score were similar for liver graft (73.7% vs 73.7%, log rank P = 0.98) and patient survival (77.6% vs 77.0%, P = 0.36). On Cox regression analysis, history of HD in deceased donors did not affect liver graft 1.02 (0.97-1.08) or patient survival 1.03 (0.97-1.09).Conclusions Among LT recipients using select liver grafts, history of HD in deceased donors does not impact outcomes after LT.