Freitas Alexandre Coutinho Teixeira de, Parolin Mônica Beatriz, Stadnik Lucinei, Coelho Júlio Cezar Uili
Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR.
Arq Gastroenterol. 2007 Jul-Sep;44(3):189-94. doi: 10.1590/s0004-28032007000300002.
Liver transplantation is the main treatment option for hepatocellular carcinoma in patients with cirrhosis.
Three months and 3 years survival were analysed in patients with cirrhosis and hepatocellular carcinoma and in patients with only cirrhosis.
Charts of patients subjected to cadaveric liver transplantation at the Clinical Hospital of the Federal University of Paraná, Curitiba, PR, Brazil, between January 5th of 2001 and February 17th of 2006 were reviewed. Patients were divided into two groups for 3 months and 1 year survival analysis: cirrhosis and hepatocellular carcinoma and cirrhosis only. The two groups were also compared in relation to donor and recipient sex and age, etiology of cirrhosis, Child-Pugh and MELD scores at the time of the transplantation, warm isquemia time, cold isquemia time, units of red blood cells transfused during the transplantation, intensive care unit stay and total hospital stay.
One hundred and forty six liver transplantation patients were analysed: 75 were excluded because of incomplete data and 71 were included. General 3 months and 1 year survivals were 77,4% and 74,6% respectively. Patients with hepatocellular carcinoma (n = 12) presented 3 months and 1 year survivals of 100%. These rates were significantly higher than those of patients without hepatocellular carcinoma (n = 59; 72,8% and 69,4%). Mean MELD score, mean Child-Pugh score and mean number of red blood cells transfused were significantly higher in patients without hepatocellular carcinoma. In this group it was also observed more Child-Pugh B and C patients and the diagnosis of cirrhosis because other causes. The rate of Child-Pugh A and hepatitis C was higher in patients with hepatocellular carcinoma. The two groups were identical in all other parameters analysed.
Patients with cirrhosis and hepatocellular carcinoma presented better 3 months and 1 year survival rates than patients with only cirrhosis. This is possibly due to an early stage of cirrhosis at transplantation of patients with hepatocellular carcinoma.
肝移植是肝硬化合并肝细胞癌患者的主要治疗选择。
分析肝硬化合并肝细胞癌患者和仅患有肝硬化患者的3个月及3年生存率。
回顾了2001年1月5日至2006年2月17日期间在巴西巴拉那联邦大学库里蒂巴临床医院接受尸体肝移植患者的病历。将患者分为两组进行3个月和1年生存率分析：肝硬化合并肝细胞癌组和仅肝硬化组。还比较了两组在供体和受体的性别与年龄、肝硬化病因、移植时的Child-Pugh和MELD评分系统分数、热缺血时间、冷缺血时间、移植期间输注的红细胞单位数、重症监护病房停留时间和总住院时间。
分析了146例肝移植患者：75例因数据不完整被排除，71例被纳入。总体3个月和1年生存率分别为77.4%和74.6%。肝细胞癌患者（n = 12）的3个月和1年生存率为100%。这些比率显著高于无肝细胞癌患者（n = 59；72.8%和69.4%）。无肝细胞癌患者的平均MELD评分系统分数、平均Child-Pugh评分系统分数和平均输注红细胞数量显著更高。在该组中还观察到更多Child-Pugh B级和C级患者以及因其他原因导致的肝硬化诊断。肝细胞癌患者中Child-Pugh A级和丙型肝炎的发生率更高。两组在所有其他分析参数方面相同。
肝硬化合并肝细胞癌患者的3个月和1年生存率高于仅患有肝硬化的患者。这可能是由于肝细胞癌患者移植时肝硬化处于早期阶段。
