Bourdeaux C, Darwish A, Jamart J, Tri TT, Janssen M, Lerut J, Otte JB, Sokal E, de Ville de Goyet J, Reding R.
小儿肝移植计划，荷兰语鲁汶大学，St-Luc大学诊所，布鲁塞尔，比利时.
及时找到合适的活供体（LD）能降低小儿肝移植（LT）的术前死亡率，我们假设以上方法能获得更好的术后结果。1993年7月至2002年4月期间，共有235名儿童进行了原位肝移植手术，其中100例为活体捐赠，135例为尸体捐赠（DD）。研究人员从人口统计学、外科学和免疫学变量等角度对二者进行了比较，并采用多变量分析法分别研究了术后并发症的影响。活体捐赠和尸体捐赠的5年存活率分别为92%和85%（ p = 0.181 ），相应的移植物存活率分别为89%和77%（p = 0.033）。通过多变量分析法的分析得出：（1）移植类型（尸体捐赠）与动脉血栓较高的发病率有关（p < 0.012）；（2）活体捐赠和尸体捐赠的5年胆道并发症发病率分别为29%和23% (p = 0.451)；（3）捐赠类型（尸体捐赠）（p = 0.001）、免疫抑制疗法（他克莫司）（p < 0.001）均与急性排斥反应发生率的降低有关。因此，我们得出了以下结论： （1）通过多变量分析法可以看出，在活体肝移植和尸体肝移植中，患者和移植物的术后结果相类似。（2）在尸体肝移植中，动脉血栓形成的发病率较高，但排斥反应发病率则较低。（3）本研究证明了无论是何种类型的器官捐赠，他克莫司对免疫预防都有疗效。
PMID: 17173657 [PubMed - indexed for MEDLINE]
Am J Transplant. 2007 Feb; 7(2):440-7. Epub 2006 Dec 6
Living-related versus deceased donor pediatric liver transplantation: a multivariate analysis of technical and immunological complications in 235 recipients
Bourdeaux C, Darwish A, Jamart J, Tri TT, Janssen M, Lerut J, Otte JB, Sokal E, de Ville de Goyet J, Reding R.
Pediatric Liver Transplant Program, Université Catholique de Louvain, Saint-Luc University Clinics, Brussels, Belgium.
Timely access to a living donor (LD) reduced pretransplant mortality in pediatric liver transplantation (LT). We hypothesized that this strategy may provide better posttransplant outcome. Between July 1993 and April 2002, 235 children received a primary LT from a LD (n = 100) or a deceased donor (DD) (n = 135). Demographic, surgical and immunological variables were compared, and respective impact on posttransplant complications was studied using a multivariate analysis. Five-year patient survival rates were 92% and 85% for groups LD and DD, respectively (p = 0.181), the corresponding graft survival rates being 89% and 77% (p = 0.033). At multivariate analysis: (1) type of donor (DD) was correlated with higher rate of artery thrombosis (p < 0.012); (2) biliary complication rate at 5 years was 29% and 23% for groups LD and DD, respectively (p = 0.451); (3) lower acute rejection incidence could be correlated with type of donor (DD) (p = 0.001), and immunosuppressive therapy (tacrolimus) (p < 0.001). We conclude that (1) according to the multivariate analysis, LT with LD provided similar patient and graft outcome, when compared to DD; (2) a higher rate of artery thrombosis and a lower rate of rejection were observed in group DD; (3) this study confirms the efficacy of tacrolimus for immunoprophylaxis, whatever the type of organ donor is.
PMID: 17173657 [PubMed - indexed for MEDLINE]
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