Salimi Javad, Jafarian Ali, Fakhar Nasir, Ramandi Alireza, Behzadi Mohamad, Moeni Ali, Dashti Habib, Najafi Atabak, Shariat Mohammad Reza, Makarem Jalil, Chavoshi Khamneh Abdolhamid
Liver Transplantation Centre, Imam Khomeini Hospital, Tehran University of Medical Siences, Tehran, Iran.
Gastroenterol Hepatol Bed Bench. 2021 Summer;14(3):237-242.
This this study aimed to investigate the causes and prognoses of liver re-transplantation in patients referred to Imam Khomeini Hospital Liver Transplantation Center.
Organ shortage is a major problem in the world, a high demand for liver transplantation has exacerbated this problem. Thus, providing more information on the causes of liver re-transplantation, its prognosis, and other issues related to this procedure is of great importance.
This study was conducted in 2018 as a historical cohort. In this study, the records of liver transplantation patients at Imam Khomeini Hospital Liver Transplantation Center between 2000 and 2016 were studied, and data was extracted from the records of patients undergoing liver transplantation. Patient data was entered into SPSS 20 software and analyzed.
In this study, 1030 patients with a mean age of 43.15 ± 14.57 years were studied. There were 426 women (41.4%) and 604 men (58.6%). The number of primary transplants was 966 with a mean age of 43.19 ± 14.72, and the number of re-transplants was 64 with a mean age of 42.56 ± 12.82. Significant differences were found between the two groups in terms of MELD and CHILD scores, cold ischemic time, total and direct bilirubin levels, liver function factors (ALT, AST, and alkaline phosphatase), hemoglobin, and WBC. There was no significant difference between the two groups in terms of age, sex, or platelets (> 0.05). The mortality rate was 241 (23.39%) in all patients and the mortality rate was 206 (21.32%) and in liver transplant patients was 35 (54.68%). The mortality rate in the transplant group was statistically higher (<0.001). Secondary was primary non-functional graft (PNF) (37.5%) with 1-, 3, and 5-year survival rates of 82%, 81%, and 70% in primary group and 59%, 43% and 32% in re-transplantation, respectively. There was a significant difference in survival between the two groups ( <0.05). Hemoglobin and alkaline phosphatase were predictors of survival rates in transplant patients.
The results of this study showed that the survival rate of re-transplant patients was significantly lower than that of primary transplant patients, and the mortality rate in re-transplant patients was significantly higher.
本研究旨在调查转诊至伊玛目霍梅尼医院肝移植中心的患者进行肝再次移植的原因及预后情况。
器官短缺是全球面临的一个主要问题，肝移植的高需求加剧了这一问题。因此，提供更多关于肝再次移植的原因、其预后以及与该手术相关的其他问题的信息非常重要。
本研究于2018年作为一项历史性队列研究开展。在本研究中，对伊玛目霍梅尼医院肝移植中心2000年至2016年间肝移植患者的记录进行了研究，并从肝移植患者的记录中提取数据。将患者数据录入SPSS 20软件并进行分析。
本研究共纳入1030例患者，平均年龄为43.15±14.57岁。其中女性426例（41.4%），男性604例（58.6%）。初次移植患者966例，平均年龄为43.19±14.72岁，再次移植患者64例，平均年龄为42.56±12.82岁。两组在终末期肝病模型（MELD）和儿童终末期肝病（CHILD）评分、冷缺血时间、总胆红素和直接胆红素水平、肝功能指标（谷丙转氨酶、谷草转氨酶和碱性磷酸酶）、血红蛋白和白细胞方面存在显著差异。两组在年龄、性别或血小板方面无显著差异（>0.05）。所有患者的死亡率为241例（23.39%），肝移植患者的死亡率为206例（21.32%），再次移植患者的死亡率为35例（54.68%）。移植组的死亡率在统计学上更高（<0.001）。其次是原发性移植物无功能（PNF）（37.5%），初次移植组1年、3年和5年生存率分别为82%、81%和70%，再次移植组分别为59%、43%和32%。两组生存率存在显著差异（<0.05）。血红蛋白和碱性磷酸酶是移植患者生存率的预测指标。
本研究结果表明，再次移植患者的生存率显著低于初次移植患者，再次移植患者的死亡率显著更高。
