使用美国本土以外的供体进行肝移植的结果

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-08-12 DOI:10.1016/j.amjsurg.2025.116568

Reed T. Jenkins , Binuri L. Hapuarachchy , Manuj M. Shah, Emily L. Larson, Alice L. Zhou, David J. Farhat, Jessica M. Ruck, Helene Rached, Elizabeth A. King, Benjamin Philosophe, Al-Faraaz Kassam

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引用次数: 0

摘要

目的扩大肝供体池包括重新考虑地理特征。我们评估了美国以外地区供体移植的人口统计、趋势和结果。方法使用国家登记数据，按供体地点（美国大陆与非大陆）对2010年至2022年的成人单肝移植进行分类。移植后生存率采用时间-事件分析、单变量和多变量Cox回归进行评估。结果1531例（1.5%）肝移植使用非大陆器官，其中991例在美国大陆进行。非大陆到大陆捐献者年龄较大，吸烟较少，BMI较低，脂肪变性较少（均p <； 0.05）。非大陆器官移动更远（1241比84英里，p < 0.01），缺血时间更长（8.6比5.9小时，p < 0.01）。住院时间（p = 0.80）和急性排斥反应（p = 0.14）无差异。非大陆接受者的生存率相似，分别为1年（aHR 1.02, p = 0.85）、5年（aHR 0.93, p = 0.38）和10年（aHR 0.96, p = 0.56）。结论非大陆受者虽然距离较远，冷缺血时间较长，但LOS和生存率相近，值得进一步考虑非大陆移植。

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Outcomes of liver transplants utilizing donors from outside the contiguous United States

Purpose

Expanding the liver donor pool includes reconsidering geographic characteristics. We evaluated demographics, trends, and outcomes of transplants from donors outside the contiguous US.

Methods

Adult liver-only transplants from 2010 to 2022 were categorized by donor location (mainland US vs. non-mainland) using national registry data. Post-transplant survival was evaluated using time-to-event analysis, univariate and multivariable Cox regression.

Results

1531 (1.5 %) liver transplants utilized non-mainland organs (991 performed in mainland US). Non-mainland to mainland donors were older, smoked less, had a lower BMI, and less steatosis (all p < 0.05). Non-mainland organs traveled further (1241 vs. 84 miles,p < 0.01) with longer ischemic times (8.6 vs. 5.9 h,p < 0.01). Length of stay (p = 0.80) and acute rejection (p = 0.14) did not differ. Non-mainland recipients had similar survival at 1-(aHR 1.02, p = 0.85), 5-(aHR 0.93, p = 0.38), and 10-years (aHR 0.96, p = 0.56).

Conclusion

Non-mainland recipients had similar LOS and survival despite longer distance and cold ischemic time, emphasizing further consideration for non-mainland transplantation.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.