引入儿科优先系统后,儿科死亡供体肝移植受者的存活率有所提高:日本全国调查数据分析。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yusuke Takemura, Masahiro Shinoda, Mureo Kasahara, Seisuke Sakamoto, Etsuro Hatano, Tatsuya Okamoto, Yasuhiro Ogura, Yukihiro Sanada, Toshiharu Matsuura, Takehisa Ueno, Hideaki Obara, Yuji Soejima, Koji Umeshita, Susumu Eguchi, Yuko Kitagawa, Hiroto Egawa, Hideki Ohdan
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引用次数: 0

摘要

背景:在日本,从未有过基于供体和受体因素的全国性小儿死亡供体肝移植(pDDLT)分析。我们构建了一个日本全国数据库,并以2018年引入的儿科优先系统为重点,评估了pDDLT的结果:我们收集了 pDDLT 的数据(结果:共纳入 112 例 pDDLT,1 年移植物存活率为 86.6%。确定了四个不良预后因素:受体重症监护室住院时间、终末期肝病模型/儿童终末期肝病评分、供体死因和供体总胆红素。引入该系统后,儿科捐献者的同种异体移植物被更可靠地分配给儿科受者,每年的 pDDLT 数量也有所增加。1年移植物存活率显著提高,风险因素显示的pDDLT情况也是如此:结论:在修订后的分配制度下,pDDLT的机会增加了,受体和供体的条件都得到了改善,存活率也提高了。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improved survival of pediatric deceased donor liver transplantation recipients after introduction of the pediatric prioritization system: Analysis of data from a Japanese national survey.

Background: In Japan, there has never been a national analysis of pediatric deceased donor liver transplantation (pDDLT) based on donor and recipient factors. We constructed a Japanese nationwide database and assessed outcomes of pDDLT focusing on the pediatric prioritization system introduced in 2018.

Methods: We collected data on pDDLTs (<18 years) performed between 1999 and 2021 from the Japan Organ Transplant Network and Japanese Liver Transplantation Society, identified risk factors for graft survival and compared the characteristics and graft survival in pDDLTs conducted before and after the introduction of the pediatric prioritization system.

Results: Overall, 112 cases of pDDLT were included, with a 1-year graft survival rate of 86.6%. Four poor prognostic factors were identified: recipient intensive care unit stay, model for end-stage liver disease/pediatric end-stage liver disease score, donor cause of death, and donor total bilirubin. After the introduction of the system, allografts from pediatric donors were more reliably allocated to pediatric recipients and the annual number of pDDLTs increased. The 1-year graft survival rate improved significantly as did pDDLT conditions indicated by the risk factors.

Conclusions: Under the revised allocation system, opportunities for pDDLT increased, resulting in favorable recipient and donor conditions and improved survival.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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