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肝移植:哈萨克斯坦一个 10 年低容量移植中心的经验。

Liver Transplantation: A 10-Year Low-Volume Transplant Center Experience in Kazakhstan.

机构信息

Department of Hepatology, Gastroenterology, and Organ Transplantation, LLP National Research Oncology Center, Nur-Sultan, Kazakhstan.

出版信息

Ann Transplant. 2021 Jul 6;26:e931786. doi: 10.12659/AOT.931786.

DOI:10.12659/AOT.931786
PMID:34226437
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8272395/
Abstract

BACKGROUND Liver transplantation is considered to be the best available treatment option for patients with liver failure. In Kazakhstan, the liver transplantation program was established a decade ago. In this study, we analyzed a low-volume transplant center experience of liver transplantation in Kazakhstan. MATERIAL AND METHODS Clinical data of the 64 consecutive liver transplantations from deceased and living donors between 2010 and 2020 were retrieved from electronic records. All data were retrospectively analyzed. RESULTS A total of 64 liver transplantations, 11 from deceased donors and 53 from living donors, were carried out in our center between 2010 and 2020. The mean age of the recipient was 44 years, 53% were female, and 47% were male. Hepatitis B+hepatitis D infection was the most common cause of end-stage liver disease (21 cases; 32.8%). The overall patient survival rates for 1, 3, and 5 years were 75%, 69.5%, and 59.6%, respectively, for recipients of a liver transplant from a living donor and 54.5%, 45.5%, and 39% for recipients of a liver transplant from a deceased donor. CONCLUSIONS Our clinical outcomes had a high rate of biliary and vascular complications that led to a low survival rate of the recipients. Starting the transplant program in Kazakhstan faced various challenges. In the early period, most transplantations were performed in collaboration with or under the guidance of transplant teams from Russia, Turkey, and South Korea. Improving surgical techniques and protocols of pre- and posttransplantation management could reduce the complications after transplantation.

摘要

背景

肝移植被认为是肝衰竭患者的最佳治疗选择。在哈萨克斯坦,肝移植项目建立于十年前。在这项研究中,我们分析了哈萨克斯坦一个低容量移植中心的肝移植经验。

材料与方法

从电子病历中检索了 2010 年至 2020 年间 64 例来自已故和活体供者的连续肝移植的临床数据。所有数据均进行回顾性分析。

结果

2010 年至 2020 年期间,我们中心共进行了 64 例肝移植,其中 11 例来自已故供者,53 例来自活体供者。受者的平均年龄为 44 岁,53%为女性,47%为男性。乙型肝炎+丁型肝炎感染是终末期肝病的最常见原因(21 例;32.8%)。接受活体供者肝移植的患者 1、3 和 5 年的总生存率分别为 75%、69.5%和 59.6%,而接受已故供者肝移植的患者分别为 54.5%、45.5%和 39%。

结论

我们的临床结果显示胆道和血管并发症发生率高,导致受者生存率低。在哈萨克斯坦启动移植项目面临着各种挑战。在早期,大多数移植都是在俄罗斯、土耳其和韩国的移植团队的合作或指导下进行的。提高手术技术和移植前后管理的方案可以减少移植后的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb4/8272395/6b32251088df/anntransplant-26-e931786-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb4/8272395/053c8c43c89b/anntransplant-26-e931786-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb4/8272395/6b32251088df/anntransplant-26-e931786-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb4/8272395/053c8c43c89b/anntransplant-26-e931786-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb4/8272395/6b32251088df/anntransplant-26-e931786-g002.jpg

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本文引用的文献

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Prevalence of HIV, HCV and HBV in Central Asia and the Caucasus: A systematic review.中亚和高加索地区 HIV、HCV 和 HBV 的流行情况:系统评价。
Int J Infect Dis. 2021 Mar;104:510-525. doi: 10.1016/j.ijid.2020.12.068. Epub 2020 Dec 29.
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Early Biliary complications after liver transplantation.肝移植术后早期胆道并发症
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Living donor liver transplant (LDLT) is the way forward in Asia.活体供肝肝移植(LDLT)是亚洲的发展方向。
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Brain Death and Transplant in Islamic Countries.伊斯兰国家的脑死亡与器官移植
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Liver Transplant Outcomes in a Newly Started Program.一个新启动项目中的肝移植结果
Exp Clin Transplant. 2015 Nov;13 Suppl 3:120-2. doi: 10.6002/ect.tdtd2015.P66.
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AASLD practice guidelines: Evaluation of the patient for liver transplantation.美国肝病研究学会实践指南:肝移植患者评估
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