Department of Internal Medicine, University of Minnesota, Minneapolis, MN; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Minnesota, Minneapolis, MN.
Liver Transpl. 2014 Jun;20(6):649-54. doi: 10.1002/lt.23855.
In this study, we describe a cohort of patients who received liver transplants before January 1, 1989 at the University of Minnesota Medical Center (UMMC), and we evaluate the health-related quality of life (HRQOL) of the survivors of this group. One hundred sixty-one patients--66 adults and 95 children--received whole deceased donor liver transplants. Thirteen transplants occurred before 1980, and all these patients died within 6 months; they were excluded from the survival analysis because they came from the pre-cyclosporine era. The survival rates at 1, 5, 10, and 20 years were 72%, 57%, 49%, and 37%, respectively (34% when pre-1980 patients were included). The median survival time was approximately 10 years for adult and pediatric recipients. The causes of death were ascertained by chart reviews. Technical failures were common between the years 1980 and 1984, and they decreased to 0% by 1988. As for HRQOL, 53 patients (36%) survived and were contacted to complete a 12-item health survey [Short Form 12 (SF-12)]. Retransplants were excluded. Sixty-eight percent returned the SF-12 survey. The median age for all respondents was 31.4 years: the median was 67.4 years for adult survivors and 28.8 years for pediatric survivors. The Mental Component Summary (MCS) score was 54.6 for adult survivors and 48.6 for pediatric survivors. The Physical Component Summary (PCS) score was 39.3 for adult survivors and 49.2 for pediatric survivors. Both the MCS and the PCS were norm-based to the US population with a mean of 50 and a standard deviation of 10. In conclusion, 35.8% of liver transplant recipients from UMMC were alive 20 years after liver transplantation. Technical failure-related deaths decreased dramatically from 1980 to 1988. The mental health of pediatric and adult survivors was similar to that of the general population. The physical health of the pediatric survivors was equivalent to that of the general population, but it was slightly less than what was expected with adjustments for age. The physical health of the adult survivors was approximately 1 standard deviation below that of the general population.
在这项研究中，我们描述了一组于 1989 年 1 月 1 日前在明尼苏达大学医学中心（UMMC）接受肝移植的患者，并评估了这群患者的健康相关生活质量（HRQOL）。共有 161 名患者——66 名成人和 95 名儿童——接受了全尸供肝移植。13 例移植发生在 1980 年前，所有这些患者均在 6 个月内死亡；由于他们来自环孢素前时代，因此被排除在生存分析之外。1 年、5 年、10 年和 20 年的生存率分别为 72%、57%、49%和 37%（包括 1980 年前的患者时为 34%）。成人和儿科受者的中位生存时间约为 10 年。通过病历回顾确定了死亡原因。1980 年至 1984 年期间技术故障较为常见，到 1988 年降至 0%。至于 HRQOL，53 名（36%）存活患者接受联系并完成了 12 项健康调查[12 项简明健康调查（SF-12）]。排除了再次移植的患者。68%的患者返回了 SF-12 调查。所有应答者的中位年龄为 31.4 岁：成人幸存者的中位数为 67.4 岁，儿科幸存者的中位数为 28.8 岁。精神健康综合评分（MCS）得分为成人幸存者 54.6，儿科幸存者 48.6。身体健康综合评分（PCS）得分为成人幸存者 39.3，儿科幸存者 49.2。MCS 和 PCS 均以美国人群的平均值 50 和标准差 10 为基准。总之，UMMC 的 35.8%肝移植受者在肝移植后 20 年仍存活。技术故障相关死亡从 1980 年到 1988 年急剧下降。儿科和成人幸存者的心理健康与一般人群相似。儿科幸存者的身体健康与一般人群相当，但考虑到年龄因素后，预期值略低。成年幸存者的身体健康状况比一般人群低约 1 个标准差。
