Gane Ed, McCall John, Streat Stephen, Gunn Kerry, Yeong Mee Ling, Fitt Sarah, Keenan Dawn, Munn Stephen
New Zealand Liver Transplant Unit, Auckland Hospital, Auckland, New Zealand.
N Z Med J. 2002 Aug 9;115(1159):U120.
To summarise the transplant-related activity of the New Zealand Liver Transplant Unit over the first four years.
The records of all patients assessed for liver transplantation between 1 December 1997 and 30 December 2001 were examined. Listing criteria, demographics, waiting time, transplant-hospitalisation details and long-term outcome for those who underwent liver transplantation were recorded.
One hundred and eighty six patients over 14 years of age (acute liver failure 28, chronic liver disease 158) were assessed and 150 were listed for liver transplantation. Fifteen died waiting, 13 were de-listed (6 for cancer progression) and 14 remain listed. One hundred and nine liver transplants (including 1 combined heart-liver, 1 sequential liver-bone marrow and 5 re-transplants) were performed on 104 patients (13 acute liver failure, 96 chronic liver failure or hepatocellular carcinoma). The median waiting time was 2 days (range 0 5) for acute liver failure and 62 days (range 0 320) for other patients. Median age at transplant was 50 years (range 14-70); 73 patients (66%) were male; 71 (65%) were European; 13 (12%) Maori; 12 (11%) Pacific Islander; and 8 (7%) Asian. Median duration of surgery was 480 minutes (range 300 720 minutes); red cell transfusion 5 units (0 32); intensive care and total hospital stays were 2 (range 1 17) and 11 days (range 6 91). One transplanted patient died in hospital, 1- and 3-year patient survival was 94% and 87% and corresponding graft survival was 91% and 83%. Ninety three transplanted patients (89%) are alive. Of the 92 patients at least three months post-transplant, 62 (67%) were employed.
Liver transplantation is now established in New Zealand as treatment of choice for acute and chronic liver failure and small hepatocellular carcinoma. Excellent outcomes have been attained in those transplanted to date. Reduction in waiting list mortality will require identification of and investment in strategies that will expand the donor organ availability.
总结新西兰肝移植中心头四年与移植相关的活动情况。
对1997年12月1日至2001年12月31日期间所有接受肝移植评估的患者记录进行审查。记录了列入移植名单的标准、人口统计学资料、等待时间、移植住院细节以及接受肝移植患者的长期预后情况。
对186例14岁以上患者（急性肝衰竭28例，慢性肝病158例）进行了评估，其中150例被列入肝移植名单。15例在等待期间死亡，13例被取消名单（6例因癌症进展），14例仍在名单上。对104例患者（13例急性肝衰竭，96例慢性肝衰竭或肝细胞癌）实施了109例肝移植手术（包括1例心脏 - 肝脏联合移植、1例肝脏 - 骨髓序贯移植和5例再次移植）。急性肝衰竭患者的中位等待时间为2天（范围0至5天），其他患者为62天（范围0至320天）。移植时的中位年龄为50岁（范围14至70岁）；73例患者（66%）为男性；71例（65%）为欧洲人；13例（12%）为毛利人；12例（
