Division of Hepatopancreatobiliary and Transplant Surgery, Department of Surgery, 6993Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Department of Gastroenterology and Hepatology, 6993Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Prog Transplant. 2020 Dec;30(4):349-354. doi: 10.1177/1526924820958142. Epub 2020 Sep 10.
Small adult patients with lower bodyweight wait-listed for liver transplantation may face a shortage of size-matched whole-liver grafts. The objective of this study is to compare time to transplantation in adult patients with a bodyweight of <60 kg to patients with bodyweight ≥60 kg.
A matched case-control study was conducted. Patients aged 18 years and older listed for liver transplantation at our transplant center, from 2007 to 2016 with a bodyweight <60 kg were manually matched 1:2 to control patients ≥ 60 kg. Matching was performed based on ABO blood type, model for end-stage liver disease score, (non)-standard exception status, and eligibility for donation after cardiac death. Time to transplantation was assessed with univariable Cox-regression.
In total, 23 cases with a bodyweight < 60 kg were matched to 46 average-sized control patients. Small adults were significantly disadvantaged for receiving a liver transplantation as compared to their average-sized counterpart (hazard ratio 0.47; 95% confidence interval 0.29-0.75, = .002). At the end of follow-up, 14/23 (60.9%) of cases versus 35/46 of controls (76.1%) had received a liver transplantation.
Small adults with a bodyweight below 60 kg are disadvantaged on the waitlist for a size-matched whole liver graft.
体重较轻的成年小患者等待肝移植时，可能面临与体型匹配的全肝移植物短缺的问题。本研究旨在比较体重 <60kg 的成年患者与体重≥60kg 的患者的移植时间。
进行了一项匹配病例对照研究。2007 年至 2016 年，在我们的移植中心，对年龄在 18 岁及以上、体重 <60kg 且登记接受肝移植的患者进行了手动 1:2 匹配，以体重≥60kg 的对照患者为对照组。匹配基于 ABO 血型、终末期肝病模型评分、（非）标准例外状态和死后供心可用性。使用单变量 Cox 回归评估移植时间。
共有 23 例体重 <60kg 的患者与 46 例平均体重的对照组患者相匹配。与平均体重的对照组相比，小成年人接受肝移植的机会明显较少（风险比 0.47；95%置信区间 0.29-0.75，=0.002）。在随访结束时，14/23（60.9%）的病例与 35/46 的对照组（76.1%）接受了肝移植。
体重低于 60kg 的成年小患者在等待与体型匹配的全肝移植物时处于不利地位。
