Jimenez-Rivera Carolina, Nightingale Scott, Benchimol Eric I, Mazariegos George V, Ng Vicky L
Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Discipline of Paediatrics and Child Health, University of Newcastle, Newcastle, NSW, Australia.
Pediatr Transplant. 2016 Nov;20(7):904-911. doi: 10.1111/petr.12756. Epub 2016 Jul 4.
LT in neonates and young infants can be challenging due to a variety of factors. To describe the waitlist mortality rates and outcomes of patients listed and transplanted as infants identified from the UNOS database. Infants listed for LT between January 1985 and September 2010 were identified from the UNOS database. Mortality on the waitlist as well as outcomes post-LT was compared between infants aged ≤60 days (Group 1), 61-179 days (Group 2), and 180-364 days (Group 3). Of 6763 infants listed for LT (Group 1 n = 496, Group 2 n = 2404, Group 3 n = 3863), mean age at listing was 196 ± 87 days (Group 1, 29 ± 16 days; Group 2, 132 ± 32 days; Group 3, 257 ± 52 days). Waitlist mortality was highest in Group 1 (Group 1 vs. 3 HR 3.01, 95% CI 2.19-4.15, Group 2 vs. Group 3 HR 0.82, 95% CI 0.66-1.03). One- and five-yr graft survival was 59.6% and 42% (Group 1), 66% and 45% (Group 2), and 66.8% and 41% (Group 3) (one-yr survival p = 0.20; five-yr survival p = 0.19). Infants listed for LT at age ≤60 days had greater waitlist mortality risk than older infants. Infants undergoing LT at age ≤60 days had similar rates of patient and graft survival to older infants.
由于多种因素，新生儿和小婴儿的肝移植具有挑战性。为描述从器官共享联合网络（UNOS）数据库中识别出的婴儿肝移植等待名单上的死亡率以及登记并接受移植患者的结局。从UNOS数据库中识别出1985年1月至2010年9月期间登记肝移植的婴儿。比较年龄≤60天（第1组）、61 - 179天（第2组）和180 - 364天（第3组）的婴儿在等待名单上的死亡率以及肝移植后的结局。在6763名登记肝移植的婴儿中（第1组n = 496，第2组n = 2404，第3组n = 3863），登记时的平均年龄为196 ± 87天（第1组，29 ± 16天；第2组，132 ± 32天；第3组，257 ± 52天）。第1组等待名单上的死亡率最高（第1组与第3组相比，风险比[HR] 3.01，95%置信区间[CI] 2.19 - 4.15；第2组与第3组相比，HR 0.82，95% CI 0.66 - 1.03）。1年和5年移植物存活率分别为59.6%和42%（第1组）、66%和45%（第2组）以及66.8%和41%（第3组）（1年存活率p = 0.20；5年存活率p = 0.19）。≤60天龄登记肝移植的婴儿比年龄较大的婴儿有更高的等待名单死亡风险。≤60天龄接受肝移植的婴儿与年龄较大的婴儿的患者和移植物存活率相似。
