纽约（路透社 健康） 调查显示，与等待尸体捐赠的肝脏相比，活体捐赠的肝脏能够降低肝移植的死亡率。

Carl Berg博士告诉记者：“我们的研究证明了活体肝移植能够大大降低肝移植受体的移植前死亡率。”

Berg博士来自美国弗吉尼亚大学，他和同事们一起分析了807例打算进行活体肝移植的受体，同时将研究发现发表在了十二月份的《胃肠病学》（Gastroenterology）杂志上。

经过平均4.4年的随访，638例患者进行了肝移植手术，其中389例为活体捐赠，249例为尸体捐赠。99例患者在等待移植的过程中死亡，70例患者仍然处在肝移植等待期。与接受尸体捐赠的肝移植受体相比，活体肝移植受体的死亡率比例风险函数为0.56。

此外，研究人员还指出，本中心已经实施了超过20例活体肝移植，也因此积累了更多的经验，所以本中心的死亡率比例风险函数降到了0.35。

研究人员写到，移植受体死亡率的下降必须兼顾活体肝移植捐赠者的风险。一项报告显示有多达38%的捐赠者会出现并发症。

然而，Berg博士总结说：“风险降低的量化能够帮助家庭成员更好的衡量活体肝移植受体获得的益处和捐赠者所承担的理论风险。”

Living Donor Liver Transplant Yields Better Survival Than Deceased Donor
NEW YORK (Reuters Health) Jan 07 - Compared to waiting for a deceased donor, use of liver from a living donor leads to reduced mortality, according to investigators.

"Our study confirms that the practice of living donor liver transplantation provides considerable reduction in risk of pre-transplant death to liver transplant candidates," lead researcher Dr. Carl Berg told Reuters Health.

Dr. Berg, of the University of Virginia, Charlottesville and colleagues analyzed data on 807 potential living donor recipients. They report their findings in the December issue of Gastroenterology.

After a median follow-up of 4.4 years, 638 had undergone liver transplant -- 389 from a living donor and 249 from a deceased donor. Ninety-nine died without transplantation and 70 were awaiting transplantation at last follow-up.Compared to those with a deceased donor, recipients from a living donor had an adjusted mortality hazard ratio of 0.56.

In addition, the researchers determined that as centers performed more than 20 living transplants and hence gained greater expertise, the mortality hazard ratio fell to 0.35.

This reduction in transplant candidate mortality, write the investigators, "must be balanced against the risks undertaken by the living donors themselves." One report indicated that as many as 38% of donors may experience complications.

Nevertheless, concluded Dr. Berg, "the quantification of this risk reduction may now allow families to more concretely balance the benefits to the living donor liver transplant recipient with the theoretical risks to the living donor."

Gastroenterology 2007;133:1806-1813

[责任编辑:刘聪]