Yoshida E M, Caron N R, Buczkowski A K, Arbour L T, Scudamore C H, Steinbrecher U P, Erb S R, Chung S W
Department of Medicine, The University of British Columbia, Vancouver, British Columbia.
Can J Gastroenterol. 2000 Oct;14(9):775-9. doi: 10.1155/2000/907463.
To study the indications for liver transplantation among British Columbia's First Nation population.
A retrospective analysis of the British Columbia Transplant Society's database of Aboriginal and non-Aboriginal liver transplant recipients from 1989 to 1998 was undertaken. For primary biliary cirrhosis (PBC), the transplant assessment database (patients with and without transplants) was analyzed using a binomial distribution and compared with published census data regarding British Columbia's proportion of Aboriginal people.
Between 1989 and 1998, 203 transplantations were performed in 189 recipients. Fifteen recipients were Aboriginal (n=15; 7.9%). Among all recipients, the four most frequent indications for liver transplantation were hepatitis C virus (HCV) infection (n=57; 30.2%), PBC (n=34; 18.0%), alcohol (n=22; 11.6%) and autoimmune hepatitis (n=14; 7.4%). Indications for liver transplantation among Aboriginal people were PBC (n=8; 53.3%; P<0.001 compared with non-Aboriginal people), autoimmune hepatitis (n=4; 26.67%; P=0.017), acute failure (n=2; 13.3%) and HCV (n=1). Among all patients referred for liver transplantation with PBC (n=43), 29 (67.44%) were white and 11 (25.6%) were Aboriginal. A significant difference was found between the proportion of Aboriginal people referred for liver transplantation and the proportion of Aboriginal people in British Columbia (139,655 of 3,698,755 [3.8%]; 1996 Census, Statistics Canada) (P<0.001).
Aboriginal people in British Columbia are more likely to be referred for liver transplantation with a diagnosis of PBC but are less likely to receive a liver transplant because of HCV or alcohol than are non-Aboriginal people.
研究不列颠哥伦比亚省原住民人群肝移植的适应证。
对不列颠哥伦比亚移植协会1989年至1998年原住民和非原住民肝移植受者数据库进行回顾性分析。对于原发性胆汁性肝硬化（PBC），使用二项分布分析移植评估数据库（有移植和无移植的患者），并与关于不列颠哥伦比亚省原住民比例的已公布人口普查数据进行比较。
1989年至1998年期间，对189名受者进行了203例移植手术。15名受者为原住民（n = 15；7.9%）。在所有受者中，肝移植最常见的四个适应证为丙型肝炎病毒（HCV）感染（n = 57；30.2%）、PBC（n = 34；18.0%）、酒精（n = 22；11.6%）和自身免疫性肝炎（n = 14；7.4%）。原住民肝移植的适应证为PBC（n = 8；53.3%；与非原住民相比，P < 0.001）、自身免疫性肝炎（n = 4；26.67%；P = 0.017）、急性肝衰竭（n = 2；13.3%）和HCV（n = 1）。在所有因PBC转诊进行肝移植的患者中（n = 43），29名（67.44%）为白人，11名（25.6%）为原住民。在因肝移植转诊的原住民比例与不列颠哥伦比亚省原住民比例之间发现显著差异（加拿大统计局1996年人口普查，不列颠哥伦比亚省3,698,755人中139,655人[3.8%]）（P < 0.001）。
与非原住民相比，不列颠哥伦比亚省的原住民因诊断为PBC而更有可能被转诊进行肝移植，但因HCV或酒精而接受肝移植的可能性较小。
