大量饮酒的已故捐献者不会影响肝移植受者的预后。

Heavy Alcohol Use Among Deceased Donors Does Not Impact Recipient Outcomes After Liver Transplantation.

机构信息

Department of Internal Medicine, University of Alabama at Birmingham-Montgomery Regional Campus, Birmingham, AL.

Department of Internal Medicine, University of Alabama at Birmingham-Huntsville Regional Campus, Birmingham, AL.

出版信息

Transplantation. 2018 Nov;102(11):1864-1869. doi: 10.1097/TP.0000000000002230.

DOI:10.1097/TP.0000000000002230

PMID:29677070

Abstract

BACKGROUND

Data on liver transplant (LT) outcomes using deceased donors with heavy drinking (HD) (>2 drinks per day) are scanty.

METHODS

Using the United Network for Organ Sharing database (2002-2014), we examined outcomes after LT in adults comparing deceased HD donors with non-HD (ND) donors.

RESULTS

Of 56 182 first LTs performed in the United States for 10 common indications using deceased donors, 47 882 with available information on alcohol use were analyzed. Of these 47 882 LT recipients, 7298 (15%) were from HD donors, with similar proportion over time (2002-2014, Armitage trend test P = 0.75) and for recipient liver disease etiology (χ P = 0.42). Proportion of liver organ used for LT was lower for HD donors compared with ND donors (63% vs 78%; P < 0.001). Five-year outcomes on first LT comparing 7166 HD donors and 21 498 ND donors matched based on propensity score were similar for liver graft (73.7% vs 73.7%, log rank P = 0.98) and patient survival (77.6% vs 77.0%, P = 0.36). On Cox regression analysis, history of HD in deceased donors did not affect liver graft 1.02 (0.97-1.08) or patient survival 1.03 (0.97-1.09).

CONCLUSIONS

Among LT recipients using select liver grafts, history of HD in deceased donors does not impact outcomes after LT.

摘要

背景

使用大量饮酒（HD）（每天>2 杯）的已故供体进行肝移植（LT）的结果数据很少。

方法

使用美国器官共享网络数据库（2002-2014 年），我们比较了已故 HD 供体与非 HD（ND）供体的成人 LT 后结果。

结果

在美国，根据 10 种常见适应症，使用已故供体进行的 56182 例首次 LT 中，对 47882 例具有酒精使用信息的患者进行了分析。在这 47882 例 LT 受者中，7298 例（15%）来自 HD 供体，且随时间的推移比例相似（2002-2014 年，Armitage 趋势检验 P=0.75），并且对于受体肝脏疾病病因（χ P=0.42）也是如此。与 ND 供体相比，HD 供体用于 LT 的肝脏器官比例较低（63%比 78%；P<0.001）。根据倾向评分匹配的首次 LT 中，7166 例 HD 供体和 21498 例 ND 供体的 5 年结果相似，肝移植物（73.7%比 73.7%，对数秩 P=0.98）和患者生存率（77.6%比 77.0%，P=0.36）。在 Cox 回归分析中，已故供体的 HD 病史并未影响肝移植物 1.02（0.97-1.08）或患者生存率 1.03（0.97-1.09）。