Hong Suk Kyun, Yi Nam Joon, Kim Hyo Sin, Ahn Sung Woo, Yoon Kyung Chul, Kim Hyeyoung, Lee Kwang Woong, Suh Kyung Suk
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2017 Jun;32(6):919-925. doi: 10.3346/jkms.2017.32.6.919.
Few studies have compared outcomes in patients undergoing liver transplantation (LT) for hepatitis B virus (HBV) and alcoholic liver disease (ALD) in Asian countries in which living donor LT (LDLT) is dominant, where HBV is endemic and where there are no strict regulations on pre-transplant abstinence for ALD. This study compared post-LT outcomes of deceased donor LT (DDLT) in patients with ALD and HBV. Data from 220 patients who underwent primary DDLT at Seoul National University Hospital from January 2010 to December 2014, including 107 with HBV and 38 with ALD, were retrospectively analyzed. Seventy-four patients (69.2%) in the HBV group and 30 (78.9%) in the ALD group had United Network for Organ Sharing (UNOS) status 2A (P = 0.250). There were no significant differences in their 1-year (90.7% vs. 92.1%) and 3-year (82.1% vs. 82.3%) overall survival rates (P = 1.000). Multivariate analysis showed that high serum gamma glutamyltransferase concentration (≥ 70 IU/L) was independently prognostic of 1-year post-LT overall survival. Survival outcomes following DDLT were similar in Korean patients with ALD and HBV, even in the absence of strict pre-transplant abstinence from alcohol as a selection criterion.
在活体肝移植(LDLT)占主导、乙型肝炎病毒(HBV)为地方病且对酒精性肝病(ALD)患者移植前戒酒无严格规定的亚洲国家,很少有研究比较过因HBV和ALD接受肝移植(LT)患者的预后情况。本研究比较了ALD和HBV患者尸体供肝肝移植(DDLT)后的预后。对2010年1月至2014年12月在首尔国立大学医院接受初次DDLT的220例患者的数据进行了回顾性分析,其中包括107例HBV患者和38例ALD患者。HBV组74例患者(69.2%)和ALD组30例患者(78.9%)的器官共享联合网络(UNOS)状态为2A(P = 0.250)。他们的1年总生存率(90.7%对92.1%)和3年总生存率(82.1%对82.3%)无显著差异(P = 1.000)。多变量分析显示,血清γ-谷氨酰转移酶浓度高(≥ 70 IU/L)是LT术后1年总生存的独立预后因素。即使没有严格的移植前戒酒作为选择标准,韩国ALD和HBV患者DDLT后的生存结果仍相似。