Görög Dénes, Gerlei Zsuzsanna, Schuller János, Dezsőfi Antal, Hartmann Erika, Piros László, Sandil Anita, Szabó József, Fehérvári Imre, Fazakas János, Doros Attila, Kóbori László
1 Semmelweis Egyetem, Általános Orvostudományi Kar, Transzplantációs és Sebészeti Klinika Budapest, Baross u. 23-25., 1082 Magyarország.
2 Uzsoki Utcai Kórház, Hepatológiai Ambulancia Budapest Magyarország.
Orv Hetil. 2022 Feb 20;163(8):301-311. doi: 10.1556/650.2022.32356.
Introduction: The Hungarian liver transplant program including waiting list started in 1995. Objective: Evaluation of the wait-list parameters and comparing them with those in the literature. Method: Data of patients listed for primary liver transplantation between 1995 and 2019 were analyzed. Results: A total of 1722 recipient candidates were registered on the liver transplant waiting list: 1608 adults (51.2% men) with mean age of 45.6 year and 114 patients aged <18 year. Virus-induced cirrhosis was the leading indication of listing (n = 451) and cholestatic liver diseases (n = 314) and alcoholic cirrhosis (n = 264) thereafter. The mean Model for End-Stage Liver Disease score was 13.5 for those with chronic disease. 61% of 1618 patients listed before December 31, 2018 underwent liver transplantation and 31% were removed from the wait-list for death or clinical deterioration. After joining Eurotransplant (period of 01. 07. 2013–31. 12. 2018), the transplant rate was 67%, the waiting list removal due to death/too sick for operation decreased to 24%. The median waiting time till transplantation was 248 days for those on elective and 2 days on acute list. Patients grafted with malignancy (n = 132) waited significantly shorter time than those with chronic non-malignant liver disease (median 115.5 versus 282 days). Discussion: The composition of our waiting list by primary liver disease was similar to that of countries with large burden of hepatitis C. Transplant rate was average, wait-list mortality and waiting time were in line with those observed in low-donation countries or in the case of large volume waiting list. Conclusion: Listing of increasing the number of patients contributed to evolution of our liver transplant program. To improve our parameters, increasing transplant activity is warranted. Orv Hetil. 2022; 163(8): 301–311.
匈牙利肝脏移植项目（包括等待名单）始于1995年。目的：评估等待名单参数并与文献中的参数进行比较。方法：分析了1995年至2019年期间登记进行初次肝脏移植的患者数据。结果：共有1722名受者候选人登记在肝脏移植等待名单上：1608名成年人（男性占51.2%），平均年龄45.6岁，114名患者年龄小于18岁。病毒诱导的肝硬化是列入名单的主要原因（n = 451），其次是胆汁淤积性肝病（n = 314）和酒精性肝硬化（n = 264）。患有慢性疾病的患者终末期肝病模型平均评分是13.5。2018年12月31日前登记的1618名患者中，61%接受了肝脏移植，31%因死亡或临床病情恶化被从等待名单中移除。加入欧洲移植组织后（2013年7月1日至2018年12月31日期间），移植率为67%，因死亡/病情过重无法手术而从等待名单中移除的比例降至24%。择期手术患者移植前的中位等待时间为248天，急症名单上的患者为2天。患有恶性肿瘤的移植患者（n = 132）等待时间明显短于患有慢性非恶性肝病的患者（中位时间分别为115.5天和282天）。讨论：我们等待名单上原发性肝病的构成与丙型肝炎负担较重国家的情况相似。移植率处于平均水平，等待名单死亡率和等待时间与低捐赠国家或等待名单规模较大情况下观察到的情况一致。结论：登记患者数量的增加推动了我们肝脏移植项目的发展。为改善我们的参数，有必要增加移植活动。《匈牙利医学周报》。2022年；163(8): 301–311。
