Dumortier Jérôme, Adham Mustapha, Ber Charles, Boucaud Catherine, Bouffard Yves, Delafosse Bertrand, Sagnard Pierre, Boillot Olivier
Liver Transplant Unit, Department of Digestive Diseases, Edouard Herriot Hospital, Lyon, France.
Liver Transpl. 2006 Dec;12(12):1770-5. doi: 10.1002/lt.20895.
While the number of candidates for liver transplantation has increased in the recent years, the pool of cadaveric donor organs has remained constant and the waiting time progressively increases. These facts led us to start a program of adult-to-adult living-donor liver transplantation in 1998. The aim of this study was to compare the outcome of all patients put on the waiting list since 1998. Between January 1, 1998, and January 1, 2005, 505 patients were put on the waiting list in our center, and living donor liver transplantation was considered in 57 cases (11.3%). At the time of evaluation (April 1, 2006), liver transplantation was performed in 377 patients (46 living donor liver transplantations), and 89 patients died on waiting list. On an intention-to-treat basis, the 1-year survival rate from the time of listing was 87.5% in the "living donor" group vs. 76.2% in the "cadaveric donor" group (P < 0.05), whereas the 1-year survival after liver transplantation was similar (92.3% vs. 86.9%). Our living donor liver transplantation program was able to improve the access to liver transplantation by reducing waiting time and the number of deaths on waiting list, despite the fact that these patients were more critically ill (liver failure and/or liver cancer).
近年来，虽然肝移植候选者的数量有所增加，但尸体供肝的数量一直保持不变，等待时间也在逐渐延长。这些情况促使我们在1998年启动了一项成人对成人活体供肝肝移植项目。本研究的目的是比较自1998年以来所有列入等待名单的患者的治疗结果。在1998年1月1日至2005年1月1日期间，有505例患者在我们中心列入等待名单，其中57例（11.3%）考虑进行活体供肝肝移植。在评估时（2006年4月1日），377例患者（46例活体供肝肝移植）接受了肝移植，89例患者在等待名单上死亡。在意向性治疗的基础上，“活体供肝”组从列入名单时起的1年生存率为87.5%，而“尸体供肝”组为76.2%（P<0.05），而肝移植后的1年生存率相似（92.3%对86.9%）。我们的活体供肝肝移植项目能够通过减少等待时间和等待名单上的死亡人数来改善肝移植的可及性，尽管这些患者病情更为严重（肝衰竭和/或肝癌）。
