Pérez-Daga J A, Ramírez-Plaza C, Suárez M A, Santoyo J, Fernández-Aguilar J L, Aranda J M, Sánchez-Pérez B, González-Sánchez A, Alvárez A, Valle M, Bondía J A
Unit of HBP Surgery and Liver Transplantation, H. R. Carlos Haya, Malaga, Spain.
Transplant Proc. 2008 Nov;40(9):2959-61. doi: 10.1016/j.transproceed.2008.09.028.
Hepatitis C virus (HCV)-cirrhosis is the most frequent indication for orthotopic liver transplantation (OLT) among adults in most European and American transplant centers. The aim of this study was to analyze the impact of donor age on graft survival among HCV-positive cirrhotic transplant patients.
We performed an observational, retrospective study between March 1997 and December 2004, analyzing 340 liver transplantations. The patients were divided into 4 groups, considering whether the HCV infection was the indication for OLT and whether the age of the donor was older or younger than 48 years: group 1 (HCV, <48 years); group 2 (HCV, >48 years); group 3 (non-HCV, <48 years); and group 4 (non-HCV, >48 years).
A univariate analysis showed that posttransplantation graft survival was clearly influenced by recipient HCV serologic status (P = .018). However, no graft survival differences were found when the analysis variable was age (>48 or <48 years). When both variables were studied, a positive HCV serology did not modify graft survival when the donor age was <48 years (P = .32), but had a statistically significant negative impact when the age was >48 years (P = .02).
The use of older donors for HCV recipients resulted in worse graft and patient survivals in our study. This difference in survival was not present in non-HCV recipients or when grafts for HCV recipients were procured from younger donors. Donor age <30 years was a protective factor for graft survival among HCV recipients.
在大多数欧美移植中心,丙型肝炎病毒(HCV)肝硬化是成人原位肝移植(OLT)最常见的适应证。本研究旨在分析供体年龄对HCV阳性肝硬化移植患者移植物存活的影响。
我们在1997年3月至2004年12月期间进行了一项观察性回顾性研究,分析了340例肝移植病例。根据HCV感染是否为OLT的适应证以及供体年龄是否大于或小于48岁,将患者分为4组:第1组(HCV,<48岁);第2组(HCV,>48岁);第3组(非HCV,<48岁);第4组(非HCV,>48岁)。
单因素分析显示,移植后移植物存活明显受受者HCV血清学状态影响(P = 0.018)。然而,当分析变量为年龄(>48岁或<48岁)时,未发现移植物存活存在差异。当对两个变量进行研究时,供体年龄<48岁时,HCV血清学阳性并未改变移植物存活情况(P = 0.32),但当年龄>48岁时,具有统计学意义的负面影响(P = 0.02)。
在我们的研究中,使用年龄较大的供体进行HCV受体移植导致移植物和患者存活率较低。这种存活差异在非HCV受体中不存在,或者当从较年轻供体获取HCV受体的移植物时也不存在。供体年龄<30岁是HCV受体移植物存活的保护因素。