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在儿科肝移植中,慢性排斥的发生率和危险因素

Peace N Dike¹, Deborah Schady², Ryan Himes³

¹Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

|September 23, 2024

概括

在儿科肝移植 (LT) 中,慢性排斥发生在5.3%的病例中. 风险因素包括PTLD,感染和T细胞排斥,导致较低的生存率.

科学领域:

儿科肝病学儿科肝病学
移植免疫学移植免疫学
器官移植器官移植

背景情况:

慢性排斥 (CR) 是肝脏全移植损失的主要原因之一.
成年人中CR患病率有所下降,但在儿科肝移植 (LT) 中仍然定义不佳.

研究的目的:

为了确定儿科LT接受者的CR发生率.
识别与CR发展相关的风险因素.
评估结果,包括移植存活率和患者存活率,在儿科LT接受者CR.

主要方法:

17年来单一中心队列的回顾性分析.
接受者特征,手术细节和CR和对照组之间的免疫抑制的比较.
统计分析以确定风险因素并评估生存率.

主要成果:

CR的发病率为5.3% (19/356) 在LT后的中位数为1.9年.
相关的风险因素包括移植后淋巴增殖障碍,感染,自身免疫性肝病,黑人种族和多个T细胞媒介排斥.
经过CR组的再移植率为15.8%,患者的存活率较低 (78.9%对91.1%).

结论:

虽然儿科LT的CR发病率低于以前报告的,但它显著影响了移植失败和患者存活率.
确定特定的风险因素对于开发有针对性的免疫抑制策略和加强移植后监测至关重要.
需要进一步的研究,以减轻儿科肝移植接受者中与CR相关的发病率和死亡率.

关键词:

在T细胞中介排斥 (TCMR) 中.自免疫性肝病是一种自身免疫性肝病.乳腺上垂症 (ductopenia) 是一种移植后的淋巴增殖性疾病 (PTLD)

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