Ohya Yuki, Okajima Hideaki, Nishimori Aya, Lee Kwang-Jong, Shirouzu Yasumasa, Yamamoto Hidekazu, Takeichi Takayuki, Asonuma Katsuhiro, Inomata Yukihiro
Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Pediatr Transplant. 2009 Nov;13(7):868-72. doi: 10.1111/j.1399-3046.2008.01075.x. Epub 2008 Dec 15.
To re-evaluate the impact of recipient age on the outcome of LDLT for BA in an era in which LDLT is the established treatment for BA in Japan. Thirty-one patients with BA who underwent LDLT were divided into four groups regarding the age at LDLT: infants <1 yr old (group A; n = 14); young children 1 to 6 yr old (group B; n = 8); school children 6 to 15 yr old (group B; n = 5); and adults > or =15 yr old (group D; n = 4). Pre-, peri-, and postoperative factors were compared among the four groups. There was no significant difference in number of the previous laparotomy among the groups. Cholestasis was the dominant indication in group A. PELD score in group B was lower than that in the other groups, and blood loss in group B was significantly less than in groups A and D. Ratio of the graft weight to the recipient's body weight (GRWR) in group A was significantly higher than in other groups. Duration of operation in group D was lower than in groups A and B, but there was no significant difference in the length of postoperative hospital stay and graft survival. Although the case volume was not big, the age of the recipient did not have any significant impact on the outcome of LDLT in our series.
在日本活体肝移植(LDLT)已成为治疗胆管闭锁(BA)的既定疗法的时代背景下,重新评估受者年龄对BA患者LDLT治疗效果的影响。将31例行LDLT的BA患者根据LDLT时的年龄分为四组:1岁以下婴儿(A组;n = 14);1至6岁幼儿(B组;n = 8);6至15岁学龄儿童(B组;n = 5);以及15岁及以上成年人(D组;n = 4)。对四组患者术前、术中和术后的因素进行比较。各组之间既往剖腹手术次数无显著差异。胆汁淤积是A组的主要适应证。B组的终末期肝病模型(PELD)评分低于其他组,且B组的失血量显著少于A组和D组。A组的移植物重量与受者体重之比(GRWR)显著高于其他组。D组的手术时间短于A组和B组,但术后住院时间和移植物存活率无显著差异。尽管病例数量不多,但在我们的系列研究中,受者年龄对LDLT的治疗效果没有任何显著影响。