非恶性终末期肝病原位肝移植的结果

Outcomes of orthotopic liver transplantation in non-malignant end-stage liver diseases.

作者信息

Sirivatanauksorn Y, Kongkaewpaisan N, Pongpaibul A, Limsrichamrern S, Mahawithitwong P, Kositamongkol P, Tovikkai C, Asavakarn S

机构信息

HepatoPancreatoBiliary and Transplant Surgery Unit, Division of General Surgery, Department of Surgery, Siriraj Organ Transplantation Center, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.

出版信息

Transplant Proc. 2014 Apr;46(3):778-81. doi: 10.1016/j.transproceed.2014.02.026.

DOI:10.1016/j.transproceed.2014.02.026

PMID:24767347

Abstract

BACKGROUND

Orthotopic liver transplantation (OLT) is an effective treatment for patients who have end-stage liver disease. The aim of this study is to compare outcomes of OLT in fulminant hepatic failure (FHF) and non-fulminant hepatic failure (non-FHF) patients.

METHODS

A retrospective review of adult patients who underwent OLT for non-malignant end-stage liver diseases between 2002 and 2011 at Siriraj Hospital was performed. All explanted liver histopathology results were reviewed. The clinical factors and overall results of OLT were analyzed.

RESULTS

Of the 137 patients, 72 patients had non-malignant diagnoses. Eleven patients were diagnosed with FHF, whereas 61 patients were in the non-FHF group. The most common indication for liver transplantation was chronic viral hepatitis. One- and 5-year survival rates (95% confidence interval) in the FHF group were 91% (51%-99%) and 91% (51%-99%), respectively, whereas those in the non-FHF group were 74% (61%-83%) and 66% (52%-77%), respectively. Multivariate cox regression analysis revealed no statistically significant difference of survival between both groups (P = .34).

CONCLUSIONS

The post-OLT outcomes in non-malignant patients were comparable between FHF and non-FHF groups in terms of survival. OLT remains the only therapeutic option for the FHF patients.

摘要

背景

原位肝移植（OLT）是终末期肝病患者的有效治疗方法。本研究旨在比较暴发性肝衰竭（FHF）和非暴发性肝衰竭（non-FHF）患者的OLT结局。

方法

对2002年至2011年在诗里拉吉医院接受OLT治疗的非恶性终末期肝病成年患者进行回顾性研究。回顾了所有切除肝脏的组织病理学结果。分析了OLT的临床因素和总体结果。

结果

137例患者中，72例为非恶性诊断。11例诊断为FHF，61例为非FHF组。肝移植最常见的指征是慢性病毒性肝炎。FHF组1年和5年生存率（95%置信区间）分别为91%（51%-99%）和91%（51%-99%），而非FHF组分别为74%（61%-83%）和66%（52%-77%）。多因素cox回归分析显示两组生存率无统计学显著差异（P = 0.34）。