Russo Mark W, LaPointe-Rudow Dianne, Kinkhabwala Milan, Emond Jean, Brown Robert S
Division of Digestive Diseases, University of North Carolina, Chapel Hill, NC, USA.
Am J Transplant. 2004 Mar;4(3):427-31. doi: 10.1111/j.1600-6143.2004.00336.x.
Studies comparing adult living donor liver transplantation to deceased donor liver transplantation have focused on post-transplant survival. Our aim was to focus on the impact of living donor liver transplant on waiting time mortality and overall mortality. We analyzed the affect of living donor liver transplantation on waiting time mortality and overall mortality (from listing until last follow up) in a cohort of 116 transplant candidates. Fifty-eight candidates who had individuals present as potential living donors (volunteer group) were matched by MELD score to 58 liver transplant candidates who did not have individuals present as a potential living donor (no volunteer group). Twenty-seven percent of candidates in the no volunteer group and 62% of candidates in the volunteer group underwent liver transplantation, p = 0.0003. One-year waiting list mortality for the volunteer group and no volunteer group was 10% and 20%, respectively, p = 0.03. Patient survival from the time of listing to last follow up was similar between the two groups. In our study group, living donor liver transplantation is associated with a higher rate of liver transplantation and lower waiting time mortality. In the era of living donor liver transplantation, estimates of patient survival should incorporate waiting time mortality.
比较成人活体肝移植与尸体肝移植的研究主要关注移植后的生存率。我们的目的是关注活体肝移植对等待期死亡率和总体死亡率的影响。我们分析了116例移植候选者队列中活体肝移植对等待期死亡率和总体死亡率（从列入名单到最后一次随访）的影响。将58例有潜在活体供者的候选者（志愿者组）按终末期肝病模型（MELD）评分与58例没有潜在活体供者的肝移植候选者（无志愿者组）进行匹配。无志愿者组27%的候选者和志愿者组62%的候选者接受了肝移植，p = 0.0003。志愿者组和无志愿者组的1年等待名单死亡率分别为10%和20%，p = 0.03。两组从列入名单到最后一次随访的患者生存率相似。在我们的研究组中，活体肝移植与更高的肝移植率和更低的等待期死亡率相关。在活体肝移植时代，患者生存率的估计应纳入等待期死亡率。
