Jacob D A, Neumann U P, Bahra M, Langrehr J M, Neuhaus P
Charité Campus Virchow, Universitätsmedizin Berlin, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Berlin.
Dtsch Med Wochenschr. 2006 Oct 20;131(42):2327-32. doi: 10.1055/s-2006-955012.
Currently liver transplantation (LTx) is the only effective curative therapy of end-stage primary biliary cirrhosis (PBC). Recent data have shown a recurrence rate of up to 32%. However, many studies are based on only a small number of patients with a marginal follow-up below 10 years. It was the aim of this study to analyse survival and complication rates after LTx among 100 patients in a long-term follow-up of up to 17 years.
Between 1989 and 2006 data of 115 patients receiving LTx for PBC at the Charité Campus Virchow were retrospectively analysed. The median age of 89 women (84%) and 17 men (16%) was 54 years (25-67).
Actuarial patient survival rate after 10 and 17 years was 88% and 83%. 13 patients (12%) died after a median survival time of 42 months (0.5-136). Two of these patients developed organ dysfunction due to recurrence of PBC. In addition, histological recurrence was found in 17 patients (16%) after a median time of 61 months (36-158). Survival analysis of hospital stay, preoperative Child-Pugh score, rejection episodes, PBC recurrence and retransplantation showed no significant results.
Long-term follow-up of up to 17 years after liver transplantation for primary biliary cirrhosis showed excellent survival rates. Both the amount and severity of postoperative complications and the preoperative Child-Pugh score did not affect the long-time survival rate significantly.
目前,肝移植(LTx)是终末期原发性胆汁性肝硬化(PBC)唯一有效的治愈性疗法。近期数据显示复发率高达32%。然而,许多研究仅基于少数患者,且随访时间不足10年。本研究旨在对100例患者进行长达17年的长期随访,分析肝移植后的生存率和并发症发生率。
回顾性分析了1989年至2006年间在夏里特医院维尔肖校区接受PBC肝移植的115例患者的数据。89名女性(84%)和17名男性(16%)的中位年龄为54岁(25 - 67岁)。
10年和17年的精算患者生存率分别为88%和83%。13例患者(12%)在中位生存时间42个月(0.5 - 136个月)后死亡。其中2例患者因PBC复发出现器官功能障碍。此外,17例患者(16%)在中位时间61个月(36 - 158个月)后出现组织学复发。对住院时间、术前Child-Pugh评分、排斥反应、PBC复发和再次移植的生存分析未显示出显著结果。
对原发性胆汁性肝硬化患者进行肝移植后长达17年的长期随访显示出优异的生存率。术后并发症的数量和严重程度以及术前Child-Pugh评分均未对长期生存率产生显著影响。