Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN, USA.
Am J Transplant. 2013 Jan;13 Suppl 1:73-102. doi: 10.1111/ajt.12021.
The current liver allocation system, introduced in 2002, decreased the importance of waiting time for allocation priorities; the number of active wait-listed candidates and median waiting times were immediately reduced. However, the total number of adult wait-listed candidates has increased since 2002, and median waiting time has increased since 2006. Pretransplant mortality rates have been stable, but the number of candidates withdrawn from the list as being too sick to undergo transplant nearly doubled between 2009 and 2011. Deceased donation rates have remained stable, with an increasing proportion of expanded criteria donors. Living donation has decreased over the past 10 years. Transplant outcomes remain robust, with continuously improving graft survival rates for deceased donor, living donor, and donation after circulatory death livers. Numbers of new and prevalent pediatric candidates on the waiting list have decreased. Pediatric pretransplant mortality has decreased, most dramatically for candidates aged less than 1 year. The transplant rate has increased since 2002, and is highest in candidates aged less than 1 year. Graft survival continues to improve for pediatric recipients of deceased donor and living donor livers. Incidence of acute rejections increases with time after transplant. Posttransplant lymphoproliferative disorder remains an important concern in pediatric recipients.
现行的肝脏分配系统于 2002 年推出，降低了等待时间对分配优先级的重要性；活跃的候补名单人数和中位数等待时间立即减少。然而，自 2002 年以来，成年候补名单人数增加，中位数等待时间自 2006 年以来增加。移植前死亡率保持稳定，但自 2009 年至 2011 年，因病情太重而无法接受移植而从名单中退出的候选人数量几乎翻了一番。已故供体捐赠率保持稳定，扩大标准供体的比例不断增加。活体捐赠在过去 10 年中有所减少。移植结果仍然强劲，已故供体、活体供体和循环死亡后供体的移植物存活率持续提高。候补名单上新出现和流行的儿科候选人数减少。儿科移植前死亡率下降，年龄小于 1 岁的候选者下降幅度最大。自 2002 年以来，移植率有所增加，年龄小于 1 岁的候选者的移植率最高。接受已故供体和活体供体肝脏的儿科受者的移植物存活率继续提高。移植后急性排斥反应的发生率随时间的推移而增加。移植后淋巴组织增生性疾病仍然是儿科受者的一个重要关注点。
