日本的肝移植：日本肝移植学会登记报告

Liver transplantation in Japan: Registry by the Japanese Liver Transplantation Society.

作者信息

Umeshita Koji, Eguchi Susumu, Egawa Hiroto, Haga Hironori, Kasahara Mureo, Kokudo Norihiro, Sakisaka Shotaro, Takada Yasutsugu, Tanaka Eiji, Eguchi Hidetoshi, Uemoto Shinji, Ohdan Hideki

机构信息

Department of Surgery, Graduate School of Medicine, Osaka University, Osaka.

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki.

出版信息

Hepatol Res. 2019 Sep;49(9):964-980. doi: 10.1111/hepr.13364. Epub 2019 Jul 18.

DOI:10.1111/hepr.13364

PMID:31081572

Abstract

As of 31 December 2017, a total of 9242 liver transplants have been carried out in 67 institutions in Japan. There were 447 deceased donor transplants (444 from heart-beating donors and 3 from non-heart-beating donors) and 8795 living-donor transplants. The annual total of liver transplants in 2017 was 416 (69 deceased donor transplants and 347 living-donor transplants). The most frequent indication was cholestatic disease, followed by neoplastic disease and hepatocellular disease. In terms of hepatocellular disease in 2017, cirrhosis due to hepatitis C and B decreased (13 and 8, respectively), whereas alcoholic cirrhosis markedly increased (32). Patient survival following transplantation from heart-beating donor (444 transplants: 1 year, 89.1%; 3 years, 85.2%; 5 years, 82.9%; 10 years, 75.4%; 15 years, 70.7%) was similar to that from living-donor (8794 transplants: 1 year, 85.0%; 3 years, 80.9%; 5 years, 78.5%; 10 years, 73.2%; 15 years, 68.5%; 20 years, 65.7%; 25 years, 64.6%). Graft survival was very much the same as patient survival (heart-beating donor: 1 year, 88.4%; 3 years, 84.5%; 5 years, 82.2%; 10 years, 74.7%; 15 years, 70.1%; living donor: 1 year, 84.3%; 3 years, 79.9%; 5 years, 77.3%; 10 years, 71.4%; 15 years, 66.3%; 20 years, 63.3%; 25 years, 61.9%). Survival data are reported according to age and sex of recipient, indication, age and sex of donor, ABO compatibility, and other factors.

摘要

截至2017年12月31日，日本67家机构共进行了9242例肝脏移植手术。其中有447例尸体供体移植（444例来自心脏跳动供体，3例来自非心脏跳动供体）以及8795例活体供体移植。2017年肝脏移植手术的年度总数为416例（69例尸体供体移植和347例活体供体移植）。最常见的适应症是胆汁淤积性疾病，其次是肿瘤性疾病和肝细胞疾病。就2017年的肝细胞疾病而言，丙型和乙型肝炎所致肝硬化有所减少（分别为13例和8例），而酒精性肝硬化显著增加（32例）。心脏跳动供体移植后的患者生存率（444例移植手术：1年，89.1%；3年，85.2%；5年，82.9%；10年，75.4%；15年，70.7%）与活体供体移植后的生存率相似（8794例移植手术：1年，85.0%；3年，80.9%；5年，78.5%；10年，73.2%；15年，68.5%；20年，65.7%；25年，64.6%）。移植物生存率与患者生存率非常相似（心脏跳动供体：1年，88.4%；3年，84.5%；5年，82.2%；10年，74.7%；15年，70.1%；活体供体：1年，84.3%；3年，79.9%；5年，77.3%；10年，71.4%；15年，66.3%；20年，63.3%；25年，61.9%）。生存数据根据受者的年龄和性别、适应症、供者的年龄和性别、ABO相容性以及其他因素进行报告。