年龄小于1岁是原位肝移植的高风险类别吗？

Is age less than 1 year a high-risk category for orthotopic liver transplantation?

作者信息

Dunn S P, Weintraub W, Vinocur C D, Billmire D F, Falkenstein K

机构信息

Department of Pediatric Surgery, St. Christopher's Hospital for Children, Temple University School of Medicine, Philadelphia, PA 19134-1095.

出版信息

J Pediatr Surg. 1993 Aug;28(8):1048-50. doi: 10.1016/0022-3468(93)90516-n.

DOI:10.1016/0022-3468(93)90516-n

PMID:8229595

Abstract

The aim of this study was to determine if age less than 1 year is a high risk group for orthotopic liver transplantation (OLT). Retrospective analysis was done of patients with liver failure who received OLT. Comparison was made between patients aged < 1 year and > 1 year with regard to survival, allograft survival, hepatic artery thrombosis, and medical status at OLT. Between January 1, 1987 and September 30, 1991, 46 children received OLT. Fifteen (35%) were < 1 year (average age, 7.93 months). Survival in children < 1 year was 80% and children > 1 year was 91%. Allograft survival in children < 1 year was 57% (21 allografts required for 12 survivors) and 78% in children > 1 year (37 allografts required for 29 survivors). Retransplantation was required in 5 of 15 children < 1 year (33%) and in 5 of 29 children (17%) > 1 year. Medical status in children < 1 year was similar to medical status in children > 1 year at the time of transplant. Children with chronic stable liver disease represented 60% of children < 1 year and 60.1% of children > 1 year. Children requiring hospitalization represented 26% of children < 1 year and 29% of children > 1 year. Children in intensive care represented 13% of children < 1 year and 11% of children > 1 year. Survival for all status groups was similar. Hepatic artery thrombosis occurred in one child < 1 year and in 2 children > 1 year. No statistical difference (chi 2 analysis) was found by age between the categories evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是确定年龄小于1岁是否为原位肝移植（OLT）的高危人群。对接受OLT的肝衰竭患者进行了回顾性分析。比较了年龄＜1岁和＞1岁患者在生存、移植物存活、肝动脉血栓形成以及OLT时的医疗状况。1987年1月1日至1991年9月30日期间，46名儿童接受了OLT。15名（35%）年龄＜1岁（平均年龄7.93个月）。年龄＜1岁儿童的生存率为80%，年龄＞1岁儿童的生存率为91%。年龄＜1岁儿童的移植物存活率为57%（12名幸存者需要21个移植物），年龄＞1岁儿童的移植物存活率为78%（29名幸存者需要37个移植物）。15名年龄＜1岁的儿童中有5名（33%）需要再次移植，29名年龄＞1岁的儿童中有5名（17%）需要再次移植。移植时年龄＜1岁儿童的医疗状况与年龄＞1岁儿童的医疗状况相似。患有慢性稳定肝病的儿童在年龄＜1岁的儿童中占60%，在年龄＞1岁的儿童中占60.1%。需要住院治疗的儿童在年龄＜1岁的儿童中占26%，在年龄＞1岁的儿童中占29%。在重症监护的儿童在年龄＜1岁的儿童中占13%，在年龄＞1岁的儿童中占11%。所有状态组的生存率相似。1名年龄＜1岁的儿童和2名年龄＞1岁的儿童发生了肝动脉血栓形成。在所评估的类别之间，按年龄未发现统计学差异（卡方分析）。（摘要截短于250字）