Paediatric Surgery Unit, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France.
University Center of Pediatric Surgery of Western Switzerland, Geneva University Hospitals, Division of Pediatric Surgery, University of Geneva, 6 Rue Willy Donze, 1205, Geneva, Switzerland.
BMC Res Notes. 2024 Mar 20;17(1):86. doi: 10.1186/s13104-024-06735-6.
We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients).
In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4-21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaired by BC (p = 0.01). Multivariate analysis identified the number of dilatation courses > 2 (p = 0.008), prolonged cold ischemia time (p = 0.004), anastomosed multiple biliary ducts (p = 0.019) and hepatic artery thrombosis (p = 0.01) as factors associated with impaired graft survival. The number of dilatation courses > 2 (p < 0.001) and intrahepatic vs anastomotic stricture (p = 0.014) were associated with management failure. Thus, repeated (> 2) radiologic dilatation courses are associated with impaired graft survival and management failure. Overall, graft but not patient survival was impaired by BC.
通过回顾性分析 1997 年至 2018 年间进行的原发性小儿肝移植（pLT）患者资料，分析小儿肝移植后发生胆管癌（BC）的管理失败的危险因素。
共有 117/620 例（19%）患者发生 BC。中位（范围）随访时间为 9（1.4-21）年。患者 1、5 和 10 年生存率分别为 88.9%、85.7%和 84.4%，肝移植物 1、5 和 10 年存活率分别为 82.4%、77.4%和 74.3%。BC 影响移植物无患者生存（p=0.01）。多变量分析确定，扩张次数>2（p=0.008）、冷缺血时间延长（p=0.004）、吻合多个胆管（p=0.019）和肝动脉血栓形成（p=0.01）是与移植物存活率降低相关的因素。扩张次数>2（p<0.001）和肝内胆管 vs 吻合口狭窄（p=0.014）与管理失败相关。因此，多次（>2 次）放射学扩张与移植物存活率降低和管理失败有关。总体而言，BC 影响移植物而非患者生存。
