香港儿科肝移植——一个可供移植的已故供体稀缺的领域。

Pediatric liver transplantation in Hong Kong-a domain with scarce deceased donors.

机构信息

Department of Surgery, The University of Hong Kong, Hong Kong, China.

出版信息

J Pediatr Surg. 2009 Dec;44(12):2316-21. doi: 10.1016/j.jpedsurg.2009.07.052.

DOI:10.1016/j.jpedsurg.2009.07.052

PMID:20006017

Abstract

AIM

The study aimed to assess the outcome of live-donor liver transplantation for pediatric patients in a region with limited access to deceased donors.

PATIENTS AND METHODS

From September 1993 to September 2008, 78 pediatric patients aged between 73 days and 17 years (mean, 40 months) received 83 liver transplants. Sixty-two were living-related liver transplantations (LRLTs), and 21 were deceased-donor liver transplantations (DDLTs). The mean follow-up period was 6.5 years. The prospectively collected data of these patients were analyzed retrospectively.

RESULTS

The 1-, 2-, and 5-year survival rates of patients and grafts were 91%, 90%, 88% and 87%, 86%, 83%, respectively. The survival rates of LRLT patients and DDLT patients were 89%, 89%, 87%, and 90%, 86%, 86%, respectively (P = .58). The survival rates of patients aged 12 months or younger and patients older than 12 months were 95%, 92%, 90% and 90%, 90%, 87%, respectively (P = .65). One live donor developed temporary peroneal palsy, and another developed lung collapse (3%, 2/62). All live donors resumed their normal activities with no difficulty.

CONCLUSION

With meticulous surgical techniques and postoperative care, it is justifiable to accept donated livers from voluntary live donors for transplantation to save pediatric patients in a place with scarce deceased donors.

摘要

目的

本研究旨在评估在一个可供使用的已故供体有限的地区，活体供肝移植为儿科患者带来的结果。

患者和方法

1993 年 9 月至 2008 年 9 月，78 名年龄在 73 天至 17 岁（平均 40 个月）的儿科患者接受了 83 次肝移植。其中 62 例为活体亲属供肝移植（LRLT），21 例为已故供体肝移植（DDLT）。平均随访时间为 6.5 年。回顾性分析了这些患者的前瞻性收集数据。

结果

患者和移植物的 1 年、2 年和 5 年生存率分别为 91%、90%、88%和 87%、86%、83%。LRLT 患者和 DDLT 患者的生存率分别为 89%、89%、87%和 90%、86%、86%（P=0.58）。12 个月或以下和 12 个月以上的患者生存率分别为 95%、92%、90%和 90%、90%、87%（P=0.65）。1 名活体供者出现暂时性腓总神经麻痹，另 1 名出现肺萎陷（3%，2/62）。所有活体供者均恢复正常活动，无困难。