Werner M J M, de Kleine R H J, Bodewes F A J A, de Boer M T, de Jong K P, de Meijer V E, Scheenstra R, Sieders E, Verkade H J J, Porte R J
Rijksuniversiteit Groningen en Universitair Medisch Centrum Groningen, Groningen.
Ned Tijdschr Geneeskd. 2017;161:D2136.
To evaluate the results of the national paediatric liver transplantation programme in the University Medical Centre (UMC) Groningen in the Netherlands during the past two decades.
Retrospective cohort study.
We analysed data from paediatric patients who underwent liver transplantation at UMC Groningen in the period 1995-2016. We compared outcomes from children who had undergone a liver transplantation in the period 1995-2005 (cohort A; n = 126) and in the period 2006-2016 (cohort B; n = 169). We performed a subanalysis in cohort B between liver transplantations with deceased donor livers (n = 132) and living donor liver transplantations (LDLT; n = 37).
In cohort A, almost all livers came from deceased donors (99%), whereas in cohort B, 37 LDLTs (22%) were performed. The median age of recipients was significantly higher in cohort A (4.4 vs. 2.5 years; p = 0.015). Postoperative complications were comparable for both cohorts. Re-transplantations within a year after transplantation were more often performed in cohort A than in cohort B (25% vs. 12%; p = 0.004). Following LDLT, there was 2 times (5.4%) an indication for re-transplantation. In cohort B the 5-year survival rate was better than in cohort A (83 vs. 71%; p = 0.014). In cohort B, 5-year survival was higher after LDLT than after transplantation with a deceased donor liver (95 vs. 81%; p = 0.025).
Outcomes after paediatric liver transplantation in the Netherlands have further improved during the past two decades. With an actuarial 5-year survival of 83% in the most recent cohort, and as high as 95% following LDLT, we can say that the UMC Groningen has a successful national paediatric liver transplant programme.
评估过去二十年中荷兰格罗宁根大学医学中心（UMC）全国儿科肝移植项目的结果。
回顾性队列研究。
我们分析了1995年至2016年期间在UMC格罗宁根接受肝移植的儿科患者的数据。我们比较了1995年至2005年期间接受肝移植的儿童（队列A；n = 126）和2006年至2016年期间接受肝移植的儿童（队列B；n = 169）的结局。我们在队列B中对使用已故供体肝脏进行的肝移植（n = 132）和活体供体肝移植（LDLT；n = 37）进行了亚分析。
在队列A中，几乎所有肝脏都来自已故供体（99%），而在队列B中，进行了37例LDLT（22%）。队列A中受者的中位年龄显著更高（4.4岁对2.5岁；p = 0.015）。两个队列的术后并发症相当。移植后一年内再次移植在队列A中比在队列B中更常见（25%对12%；p = 0.004）。LDLT后，有2次（5.4%）再次移植的指征。在队列B中，5年生存率优于队列A（83%对71%；p = 0.014）。在队列B中，LDLT后的5年生存率高于使用已故供体肝脏移植后的生存率（95%对81%；p = 0.025）。
在过去二十年中，荷兰儿科肝移植后的结局进一步改善。在最近的队列中，精算5年生存率为83%，LDLT后高达95%，我们可以说UMC格罗宁根有一个成功的全国儿科肝移植项目。
