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在西班牙多中心队列中,急性肝衰竭的肝移植趋势

Isabel Conde Amiel^1,2,3, Sara Martínez Delgado¹, Andrea Bosca Robledo^1,2

¹Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Transplant international : official journal of the European Society for Organ Transplantation

|January 1, 2026

概括

对急性肝衰竭 (ALF) 的肝移植显示,尽管自身免疫和药物诱导原因增加,但结果有所改善. 高血压和损伤等关键因素影响了接受肝移植 (LT) 的ALF患者的存活率.

科学领域:

肝病学肝病学是一种肝病学.
移植医学移植医学
临床流行病学临床流行病学

背景情况:

急性肝衰竭 (ALF) 是一种具有高死亡率的危急疾病,肝移植 (LT) 提供了一种挽救生命的干预措施.
了解ALF病因和结果的趋势对于优化患者管理和提高生存率至关重要.

研究的目的:

分析在西班牙接受肝移植的急性肝衰竭成年患者的原因,特征和结果的时间趋势.
确定接受LT的ALF患者死亡率的预测因素.

主要方法:

在2001年至2020年期间,西班牙11个中心对217个成年ALF-LT病例进行了回顾性分析.
数据分为两个10年期,以评估随时间变化的变化.
收集和分析临床,生化和结果数据,包括确定死亡率预测因素.

主要成果:

常见的ALF病因包括密码性,自身免疫性和病毒性原因,自身免疫性和药物诱导性肝损伤的趋势越来越大,以及乙型肝炎病毒的减少.
尽管感染率增加和免疫抑制更强,但LT后的并发症,如呼吸衰竭,慢性病和心血管事件减少.
在研究期间,患者死亡率从37.6%显著下降到17.9%.
在LT前的高血压,LT前的急性损伤和高血独立地与更糟糕的生存率有关.

结论:

在ALF病因和LT后的管理策略中发生了显著的时间转变.
免疫抑制治疗和重症监护的改进导致ALF患者接受LT治疗的结果更好,死亡率降低.
移植前的临床因素仍然是ALF患者生存的关键预测因素.

关键词:

急性肝衰竭是一种严重的肝衰竭.一个病因学.肝移植肝移植肝移植结果就是结果.性别差异的性别差异.

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