2022年欧洲儿童肝移植的最新进展:ELITA-ESPGHAN报告

IF 2.4 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Norman Junge, Vincent Karam, Hermien Hartog, Rene Adam, Valérie Cailliez, Giuseppe Indolfi, Marianne Samyn, Xavier Stephenne, Tudor Lucian Pop, Orit Waisbourd-Zinman, Benno Kohlmaier, Aglaia Zellos, Sara Mancell, Emmanuel Gonzales, Emanuele Nicastro, Jesus Quintero, Nicolas Richter, Nigel Heaton, Raymond Reding, Sophie Branchereau, Girish Gupte, Moritz Schmelzle, Lutz Fischer, Piotr Kalicinski, Michele Colledan, Manuel Lopez Santamaria, Ruben H de Kleine, Emer Fitzpatrick
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引用次数: 0

摘要

目的:欧洲肝移植登记处(ELTR)自1968年以来一直在收集欧洲肝移植(LT)的数据。本报告的目的是概述欧洲儿童LT (pLT)的数量、使用的技术、适应症和结果,重点关注2022年与前5年的比较。方法:ELTR和Eurotransplant (ET)数据。进行汇总统计。结果:2022年,在欧洲进行了585例plt。pLT年度数量连续第三年下降。活体供体LT占pLT的34% (n = 201)。随着时间的推移,活体捐赠的比例保持稳定。在欧洲,pLT的主要适应症是胆道闭锁。总的来说,供者的年龄在增加,这与更差的移植物存活率有关。供体类型和移植物类型对移植物和患者生存均有影响,再次移植后更明显恶化。大多数移植失败(77%)和死亡(82%)发生在移植后的前6个月内。结论:随着时间的推移,欧洲每年pLT的数量正在减少。鉴于死亡的比例一直保持稳定,死者供体器官短缺可能不是导致这一趋势的主要原因,其他因素也起了作用。由于移植物丢失和死亡率的风险在移植后的前6个月最高,因此需要关注改善围手术期护理。新技术如离体机器灌注可能有助于降低死亡供体肝移植质量下降的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Update on pediatric liver transplantation in Europe 2022: An ELITA-ESPGHAN report.

Objectives: The European Liver Transplant Registry (ELTR) has been collecting data on liver transplantation (LT) in Europe since 1968. The aim of this report is to outline the number, techniques utilized, indications for, and outcomes of pediatric LT (pLT) in Europe, focusing on the Year 2022 in comparison to the preceding 5 years.

Methods: Data were obtained from ELTR and Eurotransplant (ET). Summary statistics were performed.

Results: In 2022, 585 pLTs were performed in Europe. The annual number of pLT decreased for the third consecutive year. Living donor LT represented 34% (n = 201) of pLT. The proportion of living donation (LD) remained stable over time. The major indication for pLT in Europe is biliary atresia. Donor age is increasing overall and is associated with worse graft survival. Graft and patient survival were impacted by both types of donors and types of grafts, and were significantly worse after re-transplantation. Most graft failures (77%) and deaths (82%) occurred within the first 6 months after pLT.

Conclusion: Annual numbers of pLT in Europe are decreasing over time. Given that the proportion of LD has remained stable, the shortage of deceased donor organs may not be the major reason for this trend, and other factors play a role. A focus on improving perioperative care is needed because the risk of graft loss and mortality is highest in the first 6 months after transplantation. New techniques like ex-situ machine perfusion may help mitigate risks with declining quality of deceased donor liver grafts.

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来源期刊
CiteScore
5.30
自引率
13.80%
发文量
467
审稿时长
3-6 weeks
期刊介绍: ​The Journal of Pediatric Gastroenterology and Nutrition (JPGN) provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition.
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