Zhang M, Uhanova J, Minuk G Y
Department of Medicine, University of Manitoba, Winniped, Manitoba.
Can J Gastroenterol. 2011 Jun;25(6):307-10. doi: 10.1155/2011/986945.
A higher incidence of autoimmune disorders may predispose First Nations (FN) individuals to higher rates and more severe episodes of rejection, graft loss and mortality following liver transplantation for advanced liver disease.
A retrospective review of patient outcomes in a single centre providing long-term follow-up care for FN and non-FN patients transplanted for advanced liver disease was conducted.
A total of 20 FN and 129 non-FN charts were available for review. FN subjects were younger at transplantation (mean [± SD] age 32.4±4.1 years versus 46.3±1.4 years; P=0.00005), less often male (35% versus 58%; P=0.05), more commonly transplanted for autoimmune hepatitis (30% versus 4.7%; P=0.006), less often from urban residences (25% versus 74%; P=0.0001) and less compliant with medical care (20% versus 80%; P=0.007). After a mean follow-up period of 11.0±1.5 years and 8.4±0.5 years in FN and non-FN subjects, respectively, the incidence and severity of rejection, graft and patient survival were similar between cohorts.
Although demographic profiles, nature of the underlying disease and compliance differed, the rates and severity of rejection, graft and patient survival were similar in FN and non-FN patients who underwent liver transplantation for advanced liver disease.
自身免疫性疾病的较高发病率可能使原住民（FN）个体在因晚期肝病进行肝移植后，发生排斥反应、移植物丢失和死亡的几率更高，发作更严重。
对一个为因晚期肝病接受移植的FN和非FN患者提供长期随访护理的单一中心的患者结局进行回顾性研究。
共有20份FN患者病历和129份非FN患者病历可供审查。FN受试者移植时年龄较小（平均[±标准差]年龄32.4±4.1岁，而非46.3±1.4岁；P = 0.00005），男性比例较低（35%对58%；P = 0.05），因自身免疫性肝炎接受移植的比例更高（30%对4.7%；P = 0.006），来自城市地区的比例较低（25%对74%；P = 0.0001），且对医疗护理的依从性较差（20%对80%；P = 0.007）。在FN和非FN受试者分别平均随访11.0±1.5年和8.4±0.5年后，各队列之间排斥反应的发生率和严重程度、移植物和患者生存率相似。
尽管人口统计学特征、基础疾病性质和依从性存在差异，但因晚期肝病接受肝移植的FN和非FN患者，排斥反应的发生率和严重程度、移植物和患者生存率相似。
