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[原发性胆汁性肝硬化的肝移植:QLTS 52例患者的回顾性分析]

[Liver transplantation for primary biliary cirrhosis: retrospective analysis of 52 patients in QLTS].

作者信息

Xu Chong-En, Lynch Stephen V, Balderson Glenda A, Fawcett Jonathan, Strong Russell W, Yeong Shinn

机构信息

Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Jinan 250014, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2004 Sep;12(9):543-5.

Abstract

OBJECTIVE

Retrospectively analyzing post-transplant primary biliary cirrhosis patients to document the actual survival time, the cause of post-transplant death, and recurrences after liver transplantation in patients followed up by the Queensland Liver Transplant Service (QLTS).

METHODS

The case notes of all post-piggyback liver transplantation patients followed up by QLTS were reviewed. We analyzed the clinical characteristics of the PBC patients, post-transplant actual survival rates, the causes of post-transplant death, and risk factors of recurrence, and compared the survival rates between patients with and without liver transplantation using a European model.

RESULTS

Fifty-two post-transplant patients with 54 transplantations were identified with an average age of 53 years and a mean follow-up time of 55 months. The actual survival times of PBC patients with grafts for 1 years, 5 years and 10 years were 88.4%, 80.1%, 76.9% and 80.9%, 65.4%, 19.8%. The causes of death were MOF intra-abdominal bleeding, renal failure, sepsis and cardiovascular diseases. Comparing the survival rates between with and without transplantation, 8.5% of PBC patients have recurrences with an average recurrent time of 34 months.

CONCLUSION

(1) Liver transplantation could improve survival rates, but the optimum time for transplantation should be focused on; (2) A long-term and larger follow-up sampling should be done to understand the effects of recurrences on patient's long-term survival; (3) CsA may play a more important role in preventing recurrence of PBC than Tacrolimus

摘要

目的

对移植后原发性胆汁性肝硬化患者进行回顾性分析,以记录实际生存时间、移植后死亡原因以及昆士兰肝移植服务中心(QLTS)随访的肝移植患者移植后的复发情况。

方法

回顾QLTS随访的所有背驮式肝移植患者的病历。我们分析了原发性胆汁性肝硬化患者的临床特征、移植后的实际生存率、移植后死亡原因和复发的危险因素,并使用欧洲模型比较了肝移植患者与未肝移植患者的生存率。

结果

确定了52例移植后患者共接受了54次移植,平均年龄53岁,平均随访时间55个月。原发性胆汁性肝硬化患者移植后1年、5年和10年的实际生存率分别为88.4%、80.1%、76.9%以及80.9%、65.4%、19.8%。死亡原因包括多器官功能衰竭、腹腔内出血、肾衰竭、败血症和心血管疾病。比较移植组和未移植组的生存率,8.5%的原发性胆汁性肝硬化患者出现复发,平均复发时间为34个月。

结论

(1)肝移植可提高生存率,但应关注最佳移植时间;(2)应进行长期、更大规模的随访抽样,以了解复发对患者长期生存的影响;(3)在预防原发性胆汁性肝硬化复发方面,环孢素可能比他克莫司发挥更重要的作用。

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