Barshes NR, Udell IW, Lee TC, O'Mahony CA, Karpen SJ, Carter BA, Goss JA.
Michael E. DeBakey外科，贝勒医学院，休斯敦，德克萨斯77030，美国。
尽管儿童患者很少感染丙型肝炎病毒(HCV)，但在以原位肝移植（OLT）治疗继发于HCV的终末期肝病的小儿患者中，HCV复发的自然史并没有被很好的提及。我们对1988年1月至2005年6月期间在美国因HCV进行OLT的共67名小儿患者（< 17岁）进行了分析，67名小儿患者因HCV共进行了83次OLT。在首次OLT术后5年，患者存活率和移植肝存活率分别为71.6%和55.0%；再次移植后比例分别下降到55.0%和33.8%。列出的需要再次移植的受体占全部OLT患者的31.3%，而实际接受再次移植的受体占全部OLT患者的19.3%。绝大部分患者是由于HCV复发才进行再次移植的。每个HCV患者平均进行了1.2次OLT。因HCV进行OLT的平均间隔时间为290天。总之，小儿原位肝移植受体发生HCV复发的风险很高，需要再次移植的概率也很高。而且，继发于HCV的终末期肝病很难管理，OLT是达到患者长期存活的唯一治疗方案。Copyright 2006 AASLD
PMID: 16799942 [PubMed - indexed for MEDLINE]

Liver Transpl. 2006 Jul; 12(7):1119-23.
The natural history of hepatitis C virus in pediatric liver transplant recipients
Barshes NR, Udell IW, Lee TC, O'Mahony CA, Karpen SJ, Carter BA, Goss JA.
Michael E. DeBakey Department of Surgery, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Although rare in the pediatric population, the natural history of hepatitis C virus (HCV) recurrence in pediatric patients undergoing orthotopic liver transplantation (OLT) for end-stage liver disease secondary to HCV has not been well described. We performed an analysis of all 67 pediatric patients (< 17 years old) who have undergone OLT for HCV in the United States between 1/1988 and 6/2005. The 67 pediatric patients received a total of 83 OLTs for HCV. Following initial OLTs performed for HCV, the patient and allograft survival rates were 71.6% and 55.0%, respectively, at 5 years. Following retransplantation these rates decreased to 55.0% and 33.8%, respectively, following retransplantation. Recipients were listed for retransplantation after 31.3% of all OLTs, and overall recipients were retransplanted after 19.3% of OLTs. The overwhelming majority of retransplants were performed for HCV recurrence. A mean of 1.2 OLTs were performed per patient for HCV. The median time between OLTs for HCV was 290 days. In conclusion, the risk of HCV recurrence in pediatric OLT recipients is high and is associated with a high rate of retransplantation. Still, OLT represents the only treatment option that may achieve long-term survival in pediatric patients with end-stage liver disease secondary to HCV that is recalcitrant to medical management. Copyright 2006 AASLD
PMID: 16799942 [PubMed - indexed for MEDLINE]

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