Rodriguez Joel A, Becker Natasha S, O'Mahony Christine A, Goss John A, Aloia Thomas A
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 1709 Dryden, Suite 15.37, Houston, Texas 77030, USA.
J Gastrointest Surg. 2008 Jan;12(1):110-6. doi: 10.1007/s11605-007-0247-3. Epub 2007 Aug 21.
Hepatic hemangioendothelioma (HEH) is a vascular neoplasm with intermediate malignant potential. Outcomes after liver transplantation have only been reported as small, single-institution experiences. The purpose of this study was to evaluate patient and allograft survivals after liver transplantation in a large, multi-institutional cohort of patients with HEH.
Using the United Network for Organ Sharing (UNOS) database, we identified 110 patients with a diagnosis of HEH who underwent 126 transplants between 1987 and 2005. Patient and allograft survivals were calculated using Kaplan-Meier survival curves. Log rank tests were used to determine the influence of study variables on outcomes.
Of the 110 transplanted patients, 75 patients (68%) were female, 80 patients (73%) were Caucasian, and the median age was 36 years old (23%<4 y.o., 71%>18 y.o.). The 30-day posttransplant mortality rate was 2.4%. At a median patient follow-up interval of 24 months, 1- and 5-year patient and allograft survivals were 80% and 64%, and 70% and 55%, respectively. Pretransplant medical status, but not age, was found to statistically correlate with patient survival.
These data indicate that survivals after transplantation for HEH are favorable. Given the propensity for recurrence after resection, these data support consideration of liver transplantation for all patients with significant intrahepatic tumor burden.
肝血管内皮瘤(HEH)是一种具有中等恶性潜能的血管肿瘤。肝移植后的结果仅在小规模单机构经验中有所报道。本研究的目的是评估在一个大型多机构队列中,肝血管内皮瘤患者肝移植后的患者生存率和移植物生存率。
利用器官共享联合网络(UNOS)数据库,我们识别出110例诊断为肝血管内皮瘤的患者,他们在1987年至2005年间接受了126次移植。使用Kaplan-Meier生存曲线计算患者生存率和移植物生存率。采用对数秩检验来确定研究变量对结果的影响。
110例接受移植的患者中,75例(68%)为女性,80例(73%)为白种人,中位年龄为36岁(23%<4岁,71%>18岁)。移植后30天死亡率为2.4%。在患者中位随访间隔24个月时,1年和5年的患者生存率和移植物生存率分别为80%和64%,以及70%和55%。发现移植前的医疗状况而非年龄与患者生存率存在统计学相关性。
这些数据表明,肝血管内皮瘤移植后的生存率良好。鉴于切除后有复发倾向,这些数据支持对所有有显著肝内肿瘤负荷的患者考虑进行肝移植。