Vilatobá Mario, Mercado Miguel Ángel, Contreras-Saldivar Alan Gabriel, Leal-Villalpando Rafael Paulino, Zamudio-Bautista Jorge, García-Juárez Ignacio, Gamboa-Domínguez Armando
Departamento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Gac Med Mex. 2017;153(4):441-449. doi: 10.24875/GMM.17002673.
Orthotopic liver transplantation (OLT) is the treatment of choice for end stage liver disease. Many studies show an inverse relationship between the number of procedures and operative mortality.
The objective of the study is to show the results of our center and determine if it can have comparable results to high volumen centers.
This is a retrospective study which analyzed the information of patients with OLT at our institution from 1985 to December 31, 2012. Depending on date of transplantation, the study was divided into three stages. Stage 1: from 1985 to 1999. Stage 2: from 2000 to 2007. Stage 3: from 2008 to 2012. In the 1, 2 and 3 stage 22, 37 and 56 OLT were performed respectively.
Perioperative mortality was significantly lower between Stage 3 vs. Stage 1 and 2 (3.5% vs. 50% and 21.7%, p = 0.001). Patient survival was also better at 1 and 5 years at Stage 3 (94.4%, 87.8%) vs. era 2 (77.6%, 66.17%) and Stage 1 (47% and 29%) (p = 0.001).
In conclusion, the present results of OLT at our program are excellent despite being a low-volume center.
原位肝移植(OLT)是终末期肝病的首选治疗方法。许多研究表明手术例数与手术死亡率之间呈负相关。
本研究的目的是展示我们中心的结果,并确定其结果是否能与高手术量的中心相媲美。
这是一项回顾性研究,分析了1985年至2012年12月31日在我们机构接受OLT的患者信息。根据移植日期,该研究分为三个阶段。第1阶段:1985年至1999年。第2阶段:2000年至2007年。第3阶段:2008年至2012年。在第1、2和3阶段,分别进行了22例、37例和56例OLT。
第3阶段与第1阶段和第2阶段相比,围手术期死亡率显著降低(3.5%对50%和21.7%,p = 0.001)。第3阶段1年和5年的患者生存率也更高(94.4%,87.8%),高于第2阶段(77.6%,66.17%)和第1阶段(47%和29%)(p = 0.001)。
总之,尽管我们的中心手术量较低,但目前OLT的结果非常出色。