成人肝脏再次移植：阿根廷单中心23年经验的适应证与结局分析
Liver Re-transplantation in Adults: Indications and Outcomes Analysis of a 23-year Experience in a Single Center in Argentina.
作者信息
Bruballa R, Sanchez Thomas D, de Santl'banes E, Ciardullo M, Mattera J, Pekolj J, de Santibanes M, Ardiles V
机构信息
General Surgery Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Hepato-Pancreato-Biliary Surgery and Liver Transplantation Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
出版信息
Int J Organ Transplant Med. 2022;13(2):30-35.
BACKGROUND
Liver re-transplantation (re-LT) represents the only treatment for patients with irreversible graft failure.
OBJECTIVE
The aim of the current study was to describe the outcomes of both, patient and graft, after re- LT, at a high-volume referral center.
METHODS
Our population consisted of patients, with liver disease, who underwent re-LT in our institution between January 1996 and December 2019.
RESULTS
49 patients met the inclusion criteria. The patient's overall survival (OS) for the first year was 85% (Confidence Intervals (CI) 71-92) and 70% at five years (CI 53-82). In our population, three (6.12%) patients presented loss of graft and were included again in the transplant list; of these, one agreed to a new transplant while the remaining two died. This gave us graft survival results similar to those obtained for the re-LT patient; 85% at one year (CI 71-92) and 70% at 5 years (CI 53-82).
CONCLUSION
Our study shows that re-LT is a valid and safe treatment for both early graft dysfunction and for transplanted patients who again present end-stage liver disease, showing a satisfactory long-term evolution, with parameters comparable to primary transplantation.
背景
肝脏再次移植（re-LT）是不可逆移植物功能衰竭患者的唯一治疗方法。
目的
本研究的目的是描述在一家大型转诊中心进行再次肝脏移植后患者和移植物的结局。
方法
我们的研究对象包括1996年1月至2019年12月期间在我们机构接受再次肝脏移植的肝病患者。
结果
49例患者符合纳入标准。患者第一年的总生存率（OS）为85%（置信区间（CI）71-92），五年时为70%（CI 53-82）。在我们的研究对象中，3例（6.12%）患者出现移植物丢失并再次被列入移植名单；其中，1例同意再次移植，其余2例死亡。这使我们的移植物存活结果与再次肝脏移植患者的结果相似；一年时为85%（CI 71-92），五年时为70%（CI 53-82）。
结论
我们的研究表明，再次肝脏移植对于早期移植物功能障碍以及再次出现终末期肝病的移植患者来说是一种有效且安全的治疗方法，显示出令人满意的长期进展，其参数与初次移植相当。
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