Harring Theresa R, Nguyen N Thao T, Liu Hao, Karpen Saul J, Goss John A, O'Mahony Christine A
Michael E. DeBakey Department of Surgery, Baylor College Of Medicine, Houston, TX, USA.
Pediatr Transplant. 2013 May;17(3):271-7. doi: 10.1111/petr.12057. Epub 2013 Mar 15.
CF affects one of 2000 Caucasians, and approximately 25% are found to have CFLD for which OLT may be indicated. Timing of transplantation, contraindications, and survival are still widely debated. We report the outcomes of OLT for pediatric patients with CFLD from the largest children's hospital in the United States. Our records since September 1998 were analyzed for all patients undergoing OLT for CFLD. Nine patients were then compared to similar patients in the UNOS/OPTN database (n = 155). Survivals were calculated with the Kaplan-Meier method and compared using the log-rank test. All statistics were performed in SPSS 15.0. We performed OLT on nine pediatric patients with CFLD, with age ranging from nine to 17 yr at the time of transplant. Mean survival was 69.2 months; patient and allograft survivals at one and five yr were 88.9%, with one death at day 21 due to Aspergillus fumigatus sepsis. Two patients underwent concurrent multi-organ transplantation. One patient required double lung transplantation four yr after isolated OLT. Comparison to the UNOS/OPTN database revealed a trend toward improved survival. Patients with CF can achieve favorable outcomes after OLT, as we report excellent survivals for pediatric patients with CFLD.
囊性纤维化(CF)在2000名白种人中影响1人,约25%的患者被发现患有可能需要进行肝移植(OLT)的囊性纤维化相关肝病(CFLD)。移植时机、禁忌证和生存率仍存在广泛争议。我们报告了美国最大的儿童医院中患有CFLD的儿科患者进行OLT的结果。对自1998年9月以来所有接受CFLD的OLT患者的记录进行了分析。然后将9名患者与器官共享联合网络/器官获取与移植网络(UNOS/OPTN)数据库中的类似患者(n = 155)进行比较。采用Kaplan-Meier方法计算生存率,并使用对数秩检验进行比较。所有统计分析均在SPSS 15.0软件中进行。我们对9名患有CFLD的儿科患者进行了OLT,移植时年龄在9至17岁之间。平均生存时间为69.2个月;1年和5年时患者及移植物生存率均为88.9%,1例患者在术后第21天因烟曲霉菌败血症死亡。2例患者同时接受了多器官移植。1例患者在孤立性OLT术后4年需要进行双肺移植。与UNOS/OPTN数据库的比较显示出生存率有改善的趋势。正如我们所报告的患有CFLD的儿科患者具有出色的生存率一样,CF患者在OLT后可取得良好的结果。