Institute of Liver Studies, King's College Hospital, London, UK.
Transpl Int. 2013 Nov;26(11):1070-9. doi: 10.1111/tri.12164.
Recent data suggest an association of serum ferritin (SF) with waiting list (WL) and postliver transplant (LT) outcomes. To assess the predictive capacity of SF on pre- and post-LT outcomes, and to identify whether recipient or donor liver siderosis is associated with post-LT survival; a retrospective analysis of 1079 patients assessed for first LT, 2000-2007 was performed. Iron deposition in the liver tissue was assessed using a semi-quantitative grading system. Median age was 54 (18-82) years and 67% were male. Seventeen per cent had hepatocellular carcinoma (HCC). Median Model for End-stage Liver Disease MELD score was 14 (6-40), ferritin was 174 μg/l (4-4597) with 36.5% had a SF ≥ μg/l. Age (OR = 1.028) and MELD score (OR = 1.158) were independently associated with WL mortality (P < 0.001), whilst SF was not (P = NS). Age (OR = 1.018), HCC (OR = 1.542) and cold ischemia time (CIT) ≥ 10 h (OR = 1.418) were independently associated with post-LT survival (P < 0.05). Explant siderosis grade <2 was seen in 376 (71.7%) patients. Patients with explant siderosis grade ≥ 2 had inferior 12-month post-LT survival (P = 0.030). Presence of graft siderosis (15.8% of patients) was not associated with survival. In conclusion, we found a limited role for SF as a prognostic indicator for pre- or post-transplant survival.
最近的数据表明，血清铁蛋白（SF）与等待名单（WL）和肝移植后（LT）的结果有关。为了评估 SF 在 LT 前和 LT 后的结果预测能力，并确定受体或供体肝铁沉积是否与 LT 后生存率相关；对 2000-2007 年评估的 1079 例首次 LT 患者进行了回顾性分析。使用半定量分级系统评估肝组织中的铁沉积。中位年龄为 54 岁（18-82 岁），67%为男性。17%患有肝细胞癌（HCC）。中位终末期肝病模型 MELD 评分 14（6-40），铁蛋白 174μg/l（4-4597），36.5%的 SF≥μg/l。年龄（OR=1.028）和 MELD 评分（OR=1.158）与 WL 死亡率独立相关（P<0.001），而 SF 则没有（P=NS）。年龄（OR=1.018）、HCC（OR=1.542）和冷缺血时间（CIT）≥10 h（OR=1.418）与 LT 后生存率独立相关（P<0.05）。376 例（71.7%）患者的移植前铁沉积分级<2。移植前铁沉积分级≥2 的患者 LT 后 12 个月生存率较低（P=0.030）。移植物铁沉积的存在（15.8%的患者）与生存率无关。总之，我们发现 SF 作为 LT 前或 LT 后生存的预后指标的作用有限。
