Hou Yifu, Wang Xiaoxiao, Yang Hongji, Zhong Shan
Department of Organ Transplantation, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Front Pediatr. 2021 Apr 29;9:628771. doi: 10.3389/fped.2021.628771. eCollection 2021.
Modern surgical techniques and scientific advancements have made liver transplant (LT) in infants feasible. However, there are only a small number of studies examining the short- as well as long-term outcomes of LT in this vulnerable subset of children. Comprehensive searches were done systematically through the PubMed, Scopus, and Google scholar databases. Studies that were retrospective record based or adopted a cohort approach and reported either patient survival rates or graft survival rates or complications of LT in infants were included in the meta-analysis. Statistical analysis was done using STATA version 13.0. A total of 22 studies were included in the meta-analysis. The overall pooled patient survival rate at 1 year, >1-5 years, and >5 years post-transplantation was 85% (95% CI: 78--92%), 71% (95% CI: 59-83%), and 80% (95% CI: 69-91%), respectively. The overall pooled graft survival rate at 1 year, >1-5 years, and >5 years post-transplantation was 72% (95% CI: 68-76%), 62% (95% CI: 46-78%), and 71% (95% CI: 56-86%), respectively. The overall pooled rate for vascular complications, need for re-transplantation, biliary complications, and infection/sepsis was 12% (95% CI: 10-15%), 16% (95% CI: 12-20%), 15% (95% CI: 9-21%), and 50% (95% CI: 38-61%), respectively. The current meta-analysis showed modest patient and graft survival rates for infant liver transplantation. However, the complication rates related to infection/sepsis were high. More comprehensive evidence is required from studies with larger sample sizes and a longer duration of follow-up.
现代外科技术和科学进步已使婴儿肝移植（LT）成为可能。然而，仅有少数研究考察了这一脆弱儿童亚组肝移植的短期和长期结局。通过PubMed、Scopus和谷歌学术数据库系统地进行了全面检索。纳入荟萃分析的研究为基于回顾性记录或采用队列研究方法，并报告了婴儿肝移植的患者生存率、移植物生存率或并发症情况。使用STATA 13.0进行统计分析。荟萃分析共纳入22项研究。移植后1年、>1至5年和>5年的总体合并患者生存率分别为85%（95%CI：78 - 92%）、71%（95%CI：59 - 83%）和80%（95%CI：69 - 91%）。移植后1年、>1至5年和>5年的总体合并移植物生存率分别为72%（95%CI：68 - 76%）、62%（95%CI：46 - 78%）和71%（95%CI：56 - 86%）。血管并发症、再次移植需求、胆道并发症以及感染/脓毒症的总体合并发生率分别为12%（95%CI：10 - 15%）、16%（95%CI：12 - 20%）、15%（95%CI：9 - 21%）和50%（95%CI：38 - 61%）。当前的荟萃分析显示婴儿肝移植的患者和移植物生存率一般。然而，与感染/脓毒症相关的并发症发生率较高。需要来自更大样本量和更长随访时间研究的更全面证据。
