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供体和受体种族对丙型肝炎相关肝移植后生存的影响。

Impact of donor and recipient race on survival after hepatitis C-related liver transplantation.

机构信息

Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.

出版信息

Transplantation. 2012 Feb 27;93(4):444-9. doi: 10.1097/TP.0b013e3182406a94.

Abstract

BACKGROUND

Both donor and recipient race impact outcomes after liver transplantation (LT), especially for hepatitis C virus (HCV). The interaction and simultaneous impact of both on patient survival is not clearly defined. The purpose of this study was to examine the impact of donor and recipient race on recipient and graft survival after HCV-related LT using the United Network for Organ Sharing database.

METHODS

A total of 16,053 recipients (75.5% white, 9.3% black, and 15.2% Hispanic) who underwent primary LT for HCV between 1998 and 2008 were included. Cox regression models were used to assess the association between recipient/donor race and patient survival.

RESULTS

A significant interaction between donor and recipient race was noted (P=0.01). Black recipients with white donors had a higher risk of patient mortality (adjusted hazard ratio, 1.66; 95% confidence interval, 1.47-1.87) compared with that of white recipients with white donors. In contrast, the pairing of Hispanic recipients with black donors was associated with a lower risk of recipient mortality compared with that of white recipients with white donors (adjusted hazard ratio, 0.64; 95% confidence interval, 0.46-0.87). Similar results were noted for graft failure.

CONCLUSION

In conclusion, the impact of donor and recipient race on patient survival varies substantially by the matching of recipient/donor race.

摘要

背景

供体和受体的种族都会影响肝移植(LT)后的结果,尤其是丙型肝炎病毒(HCV)。供体和受体种族对患者生存的相互作用和同时影响尚不清楚。本研究的目的是使用器官共享联合网络数据库,检查供体和受体种族对 HCV 相关 LT 后受体和移植物存活的影响。

方法

共纳入 16053 名(75.5%为白人,9.3%为黑人,15.2%为西班牙裔)在 1998 年至 2008 年间因 HCV 接受初次 LT 的受者。采用 Cox 回归模型评估受者/供者种族与患者生存之间的关系。

结果

注意到供体和受体种族之间存在显著的相互作用(P=0.01)。与白人受者接受白人供者相比,黑人受者接受白人供者的患者死亡率风险更高(调整后的危险比,1.66;95%置信区间,1.47-1.87)。相比之下,与白人受者接受白人供者相比,西班牙裔受者接受黑人供者与受体死亡率风险降低相关(调整后的危险比,0.64;95%置信区间,0.46-0.87)。移植物衰竭也有类似的结果。

结论

总之,供体和受体种族对患者生存的影响因受体/供体种族的匹配而有很大差异。

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