酒精性肝病的活体肝移植

Living Donor Liver Transplantation for Alcoholic Liver Disease.

作者信息

Braun Hillary J, Ascher Nancy L

机构信息

Department of Surgery, University of California, San Francisco, Box 0780, 505 Parnassus Avenue, M884, San Francisco, CA 94117, USA.

出版信息

Alcohol Alcohol. 2018 Mar 1;53(2):178-183. doi: 10.1093/alcalc/agx099.

DOI:10.1093/alcalc/agx099

PMID:29370340

Abstract

AIMS

Alcoholic liver disease (ALD) is now a well-recognized indication for liver transplantation. This paper reviews existing literature on living donor liver transplantation (LDLT) for ALD and presents data from a single, high volume United States liver transplant center.

METHODS

For the literature review, a PubMed search was undertaken using the search terms 'living donor' and 'alcoholic liver disease'. Studies were included that presented outcome data for patients who underwent LDLT for ALD. For the single-center data collection, all patients who underwent LDLT from 2003 to 2016 at our center were reviewed and the data for recipients with ALD was subsequently analyzed and compared with those patients who underwent LDLT for other indications.

RESULTS

Of 110 studies that resulted from the PubMed query, only 5 contained data that was relevant to this manuscript. These studies represented data collected from two Asian countries: one single center in Korea and a collection of centers in Japan. The relapse rate following LDLT for ALD ranged from 7.9% to 22%, and pre-transplant abstinence did not impact post-transplant relapse in any of these studies. For the single-center data, of 136 LDLT performed at our institution during the time period, 22 were performed for ALD. There was no difference in 1- or 5-year survival between patients transplanted for ALD and those transplanted for other etiologies (94.7% vs. 93.4%, P = 0.79 and 78.9% vs. 87.5%, P = 0.6).

CONCLUSION

There is a very limited amount of data available on LDLT for ALD. Existing data suggests that LDLT for ALD results in excellent outcomes.

SHORT SUMMARY

Published data on living donor liver transplantation (LDLT) for alcoholic liver disease (ALD) are limited. One- and five-year survival rates range from 82% to 100% and 78% to 87%, respectively. Rates of alcohol relapse following transplant appear low, ranging from 7% to 23%; 6-month abstinence periods prior to LDLT for ALD do not appear to have a significant impact on relapse.

摘要

目的

酒精性肝病（ALD）目前是公认的肝移植适应证。本文回顾了关于活体肝移植（LDLT）治疗ALD的现有文献，并展示了来自美国一家大型肝移植中心的数据。

方法

对于文献综述，使用搜索词“活体供体”和“酒精性肝病”在PubMed上进行检索。纳入的研究需提供接受LDLT治疗ALD患者的结局数据。对于单中心数据收集，回顾了2003年至2016年在我们中心接受LDLT的所有患者，并随后分析了ALD受者的数据，并与因其他适应证接受LDLT的患者进行比较。

结果

PubMed检索结果中的110项研究中，只有5项包含与本文相关的数据。这些研究代表了从两个亚洲国家收集的数据：韩国的一个单中心和日本的一组中心。ALD患者LDLT后的复发率在7.9%至22%之间，在这些研究中，移植前戒酒对移植后复发均无影响。对于单中心数据，在该时间段内我们机构进行的136例LDLT中，有22例是针对ALD进行的。因ALD接受移植的患者与因其他病因接受移植的患者在1年或5年生存率方面无差异（94.7%对93.4%，P = 0.79；78.9%对87.5%，P = 0.6）。