Thuluvath Paul J, Krok Karen L, Segev Dorry L, Yoo Hwan Y
Section of Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Liver Transpl. 2007 May;13(5):719-24. doi: 10.1002/lt.21123.
It has been suggested that the post-liver transplantation (LT) survival rate of patients with hepatitis C virus infection (HCV) has declined in recent years. To compare the outcome of LT in patients with HCV at various time intervals between 1991 and 2001, we used United Network for Organ Sharing data to compare the post-LT survival of adult patients (age >18 years) with HCV with those without HCV. Of the 37,101 patients who underwent LT during the study period, 28,193 patients (HCV 7,459 and 20,734 non-HCV) were eligible for the study. On the basis of the time of transplantation, patients were divided into 3 groups: 1991-1993 (period 1), 1994-1997 (period 2), and 1998-2001 (period 3). The patient and graft survival rates were adjusted for other known confounding variables that influenced outcomes. The 3-year patient survival rate was lower in HCV patients compared with non-HCV recipients (78.5% vs. 81.4%, hazard ratio 1.14, 95% confidence interval 1.05-1.23, P = 0.001). The graft (72.8%, 71.0%, and 69.8%) and patient (77.4%, 79.6%, and 78.5%) survival of HCV patients remained unchanged during study periods 1-3, respectively. However, the graft and patient survival rates of non-HCV recipients improved markedly during study periods 2 and 3 compared with period 1. The graft and patient survival has remained unchanged between 1991 and 2001 in HCV recipients, but during the same period, there was a great improvement in survival among non-HCV recipients.
有人提出，近年来丙型肝炎病毒感染（HCV）患者肝移植（LT）后的生存率有所下降。为比较1991年至2001年不同时间段HCV患者LT的结果，我们使用器官共享联合网络数据，比较了成年HCV患者（年龄>18岁）与非HCV患者LT后的生存率。在研究期间接受LT的37101例患者中，28193例患者（HCV患者7459例，非HCV患者20734例）符合研究条件。根据移植时间，患者分为3组：1991 - 1993年（第1期）、1994 - 1997年（第2期）和1998 - 2001年（第3期）。对影响结果的其他已知混杂变量进行了患者和移植物生存率的校正。与非HCV受者相比，HCV患者的3年患者生存率较低（78.5%对81.4%，风险比1.14，95%置信区间1.05 - 1.23，P = 0.001）。在第1 - 3期研究期间，HCV患者的移植物（72.8%、71.0%和69.8%）和患者（77.4%、79.6%和78.5%）生存率分别保持不变。然而，与第1期相比，非HCV受者在第2期和第3期研究期间的移植物和患者生存率显著提高。1991年至2001年，HCV受者的移植物和患者生存率保持不变，但在同一时期，非HCV受者的生存率有了很大提高。
