Zhang Ying-Cai, Yang Yang, Zhang Qi, Li Hua, Wang Gen-Shu, Zhang Jian, Xu Chi, Yi Shu-Hong, Yi Hui-Min, Cai Chang-Jie, Lu Min-Qiang, Chen Gui-Hua
Liver Transplant Center, the Third Affiliated Hospital of Sun Yat-sen University, Transplantation Research Institute of Sun Yat-sen University, Guangzhou 510630, China.
Zhonghua Wai Ke Za Zhi. 2010 Jul 15;48(14):1083-7.
To find out the risk factors predicting long-term survival, and to explore the measures for further improving the survival outcome of whom underwent liver transplantation (LT) for benign end-stage liver disease.
The common causes of late death after LT and risk factors were retrospectively analyzed in 221 consecutive patients, who underwent LT from October 2003 to June 2007 and survived more than one year. Twenty-six potential risk factors were assessed by the Kaplan-Meier method, and those variables found to be univariately significant at P < 0.10 were entered into a backward step down Cox proportional hazard regression analysis to screen the independent risk factors influencing the recipient's long-term survival.
There were 28 recipients died one year later after LT during the follow-up period. The major causes of late mortality were related to infectious complications 5.0% (11/221), biliary complications 3.6% (8/221) and HBV recurrence/reinfection 1.4% (3/221). After Cox proportional hazard regression analysis, 5 covariables finally retained in the formula were: age (RR = 2.325, P = 0.009), ABO blood group (RR = 2.206, P = 0.015), cold ischemia time (RR = 3.001, P = 0.000), post-infection region (RR = 1.665, P = 0.007) and biliary complications (RR = 2.655, P = 0.004).
Age (≥ 60 years), ABO blood group (incompatible), cold ischemia time (> 12 h), infectious complications (lung infection) and biliary complications (diffuse biliary stricture) significantly impact patient's survival time.
找出预测长期生存的危险因素，并探索进一步改善良性终末期肝病患者肝移植（LT）生存结局的措施。
回顾性分析2003年10月至2007年6月期间连续接受LT且存活超过1年的221例患者LT术后晚期死亡的常见原因及危险因素。采用Kaplan-Meier法评估26个潜在危险因素，将单因素分析中P<0.10具有显著意义的变量纳入向后逐步Cox比例风险回归分析，以筛选影响受者长期生存的独立危险因素。
随访期间有28例受者在LT术后1年以后死亡。晚期死亡的主要原因与感染并发症5.0%（11/221）、胆道并发症3.6%（8/221）和HBV复发/再感染1.4%（3/221）有关。经过Cox比例风险回归分析，最终保留在公式中的5个协变量为：年龄（RR = 2.325，P = 0.009）、ABO血型（RR = 2.206，P = 0.015）、冷缺血时间（RR = 3.001，P = 0.000）、感染后部位（RR = 1.665，P = 0.007）和胆道并发症（RR = 2.655，P = 0.004）。
年龄（≥60岁）、ABO血型（不相合）、冷缺血时间（>12小时）、感染并发症（肺部感染）和胆道并发症（弥漫性胆管狭窄）显著影响患者的生存时间。
