Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Via Giustiniani 2, Padua, Italy.
Transplantation. 2013 Jun 27;95(12):1528-34. doi: 10.1097/TP.0b013e318292827f.
Numerous donor and recipient risk factors influence survival after liver transplantation (LT).
The aim of this study was to prospectively evaluate the effect of donor and recipient variables on 12-month patient and graft survival after LT. Five hundred forty-six patients underwent LT in a single center (2000-2010).
Bilirubin (P=0.006) and cold ischemia time (P=0.002) were predictive of graft loss at 12 months after LT. Model for End-Stage Liver Disease score ≥25 was associated with a lower 12-month graft survival than Model for End-Stage Liver Disease score <15 (P=0.02). Hepatitis C virus (HCV)-positive patients showed a lower survival than HCV-negative patients 12 months after LT (P=0.04), with serum sodium concentration (P=0.01) predictive for graft survival. Donor age demonstrated a trend of prediction (P=0.05) for HCV-positive patient survival. In hepatocellular carcinoma patients, donor age (P=0.02 and 0.02) and use of partial graft (P=0.01 and 0.02) were predictive of patient and graft survival at 12 months after LT.
Bilirubin and cold ischemia time are crucial for graft outcome post-LT. Survival in HCV-positive patients is lower than in HCV-negative recipients. Donor age and partial graft use are predictive of patient and graft survival in hepatocellular carcinoma patients.
许多供体和受体的风险因素影响肝移植（LT）后的存活率。
本研究的目的是前瞻性评估供体和受体变量对 LT 后 12 个月患者和移植物存活率的影响。546 例患者在一个中心（2000-2010 年）接受 LT。
胆红素（P=0.006）和冷缺血时间（P=0.002）是 LT 后 12 个月移植物丢失的预测因素。终末期肝病模型评分≥25 与终末期肝病模型评分<15 的 12 个月移植物存活率较低相关（P=0.02）。HCV 阳性患者的存活率低于 HCV 阴性患者 12 个月后 LT（P=0.04），血清钠浓度（P=0.01）是移植物存活的预测因素。供体年龄对 HCV 阳性患者的存活有预测趋势（P=0.05）。在肝细胞癌患者中，供体年龄（P=0.02 和 0.02）和使用部分移植物（P=0.01 和 0.02）是 LT 后 12 个月患者和移植物存活的预测因素。
胆红素和冷缺血时间是 LT 后移植物结局的关键。HCV 阳性患者的存活率低于 HCV 阴性患者。供体年龄和部分移植物的使用是肝细胞癌患者患者和移植物存活的预测因素。
