Pagnozzi Janet, Álvarez Yuri, González-Pinto Ignacio
Área de Gestión Clínica de Geriatría, Hospital Monte Naranco, Avenida Doctores Fernández Vega 107, 33012 Oviedo, Spain.
Área de Teoría de la Señal y Comunicaciones, Universidad de Oviedo, Edificio Polivalente, Módulo 8, Campus Universitario de Gijón, 33203 Gijón, Spain.
J Clin Med. 2023 Jul 27;12(15):4934. doi: 10.3390/jcm12154934.
Spain has the highest rates of liver transplantation (LT) per million inhabitants in the world, with the profiles of both donors and recipients in Asturias, a region in northern Spain, being different from the rest of the country. The main goal of this study was to carry out a preliminary analysis of the characteristics of LT recipients in Asturias, as well as of the basic characteristics of surgery and the postoperative period, and to discuss whether the results obtained in this study were comparable to what is described in the literature. This was a retrospective, descriptive, cross-sectional study, analyzing the LT carried out in a reference center of Asturias between 2002 and 2017. Relative and absolute frequency distributions for qualitative variables are provided, as are position and dispersion measures for quantitative variables. Using the multivariate Cox regression model, the prognostic factors associated with overall survival were determined. A total of 533 LTs were analyzed; 431 were men and 102 were women. The mean age was 55.1 years, concentrated between 40 and 69 years for both genders. LT was performed for chronic parenchymal liver disease (mostly of alcoholic etiology) and the recipients underwent surgery in an advanced stage of liver disease. Of these recipients, 8.1% (43 patients) were retransplantions, 65.1% in the first year due to primary graft dysfunction and complete hepatic artery thrombosis. Most patients had presented a grade II of Clavien-Dindo as the most frequent complication. Biliary complications were found in 12.3% of patients, with the main cause of death in the first 30 days being instability in the 24 h after LT. The median survival of the group was 13 years, with a 5-year survival probability of 79.3% and a 10-year survival probability of 61.9%. In view of the analyzed series, it can be concluded that the most frequent recipient profile was a male patient (mean age 55 years), with a significant alcohol habit, who was overweight, with chronic parenchymal liver disease of alcoholic or viral etiology, and who had reached the Child C stage before LT. This study could lay the foundations for future studies, to complete this analysis with the characteristics of LT surgery, its postoperative period, and the follow-up after discharge, to obtain a broader view of LT recipients in this region.
西班牙是世界上每百万居民肝移植(LT)率最高的国家,西班牙北部地区阿斯图里亚斯的供体和受体情况与该国其他地区不同。本研究的主要目的是对阿斯图里亚斯肝移植受者的特征、手术及术后基本特征进行初步分析,并讨论本研究结果与文献报道是否具有可比性。这是一项回顾性、描述性横断面研究,分析了2002年至2017年在阿斯图里亚斯一家参考中心进行的肝移植手术。提供了定性变量的相对和绝对频率分布,以及定量变量的位置和离散度测量。使用多变量Cox回归模型确定与总生存相关的预后因素。共分析了533例肝移植手术;其中男性431例,女性102例。平均年龄为55.1岁,男女均集中在40至69岁之间。肝移植手术针对慢性实质性肝病(大多为酒精性病因)进行,且受者在肝病晚期接受手术。这些受者中,8.1%(43例患者)为再次移植,65.1%在第一年因原发性移植物功能障碍和完全性肝动脉血栓形成。大多数患者出现Clavien-Dindo二级作为最常见的并发症。12.3%的患者出现胆道并发症,术后30天内主要死亡原因是肝移植术后24小时内的不稳定。该组患者的中位生存期为13年,5年生存概率为79.3%,10年生存概率为61.9%。鉴于所分析的系列研究,可以得出结论,最常见的受者情况是男性患者(平均年龄55岁),有显著饮酒习惯,超重,患有酒精性或病毒性病因的慢性实质性肝病,且在肝移植前已达到Child C期。本研究可为未来研究奠定基础,通过肝移植手术特征、术后情况及出院后随访来完善该分析,以更全面地了解该地区肝移植受者情况。