活着的捐赠者整体和部分肝脏移植,已故捐赠者整体肝脏和SPLIT:结果比较
João Seda Neto1, Carolina M Costa1, Renata Pugliese1
1Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, SP, Brazil; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, SP, Brazil.
Journal of pediatric surgery
|February 27, 2024
概括
儿童肝移植结果在所有移植类型中都是相似的,包括来自已故和活体捐赠者的整体和部分移植. 然而,肝动脉血栓和恶性瘤与儿科肝移植中更差的移植存活率有关.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 儿科胃肠病学 儿科胃肠病学
背景情况:
- 儿科肝移植 (PLT) 使用来自已故捐赠者 (DD) 或活体捐赠者 (LD) 的整体 (WL) 和部分 (P) 移植.
- 活体供体全肝移植也被称为多米诺 LT.
- 在这些移植选项中比较结果对于优化PLT策略至关重要.
研究的目的:
- 为了比较使用不同种类移植的儿科肝移植的结果.
- 评估移植来源 (DD与LD) 和移植大小 (WL与P) 对患者和移植生存的影响.
- 在PLT.中确定与患者存活率下降和移植损失相关的因素.
主要方法:
- 回顾性队列研究 (2010年1月 - 2022年12月) 分析了4个组:SPLIT,DD-WL,LD-WL和LD-P.
- 收集的数据包括接受者的术前状态,术后细节和术后并发症.
- 进行了生存分析,以比较两组之间的结果.
主要成果:
- 与DD-WL相比,SPLIT,LD-P和LD-WL组的接受者更年轻,体重更低.
- 肝动脉血栓症 (HAT) 和恶性瘤与移植存活率降低显著相关.
- 虽然整体患者和移植生存率在各组之间没有统计学上的差异,但LD-P和LD-WL显示出更好的结果的趋势.
结论:
- 肝动脉血栓和恶性瘤是儿童肝移植中移植存活率降低的独立风险因素.
- 活体供体全肝移植在特定情况下显示出优异的长期患者存活率.
- 尽管没有统计差异,但活体捐赠者的部分和全肝移植可能会在儿科肝移植中改善结果.
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