Primary Liver Transplantation for Autoimmune Hepatitis: A Comparative Analysis of the European Liver Transplant Registry

被引：58

作者：

Schramm, Christoph ^{[1
]}

Bubenheim, Michael ^{[2
]}

Adam, Rene ^{[3
]}

Karam, Vincent ^{[3
]}

Buckels, John ^{[4
]}

O'Grady, John G. ^{[5
]}

Jamieson, Neville ^{[6
]}

Pollard, Stephen ^{[7
]}

Neuhaus, Peter ^{[8
]}

Manns, Michael M. ^{[9
]}

Porte, Robert ^{[10
]}

Castaing, Denis ^{[3
]}

Paul, Andreas ^{[11
]}

Traynor, Oscar ^{[12
]}

Garden, James ^{[13
]}

Friman, Styrbjorn ^{[14
]}

Ericzon, Bo-Goran ^{[15
]}

Fischer, Lutz ^{[16
]}

Vitko, Stefan ^{[17
]}

Krawczyk, Marek ^{[18
]}

Metselaar, Herold J. ^{[19
]}

Foss, Aksel ^{[20
]}

Kilic, Murat ^{[21
]}

Rolles, Keith ^{[22
]}

Burra, Patrizia ^{[23
]}

Rogiers, Xavier ^{[24
]}

Lohse, Ansgar W. ^{[1
]}

机构：

[1] Univ Med Ctr Hamburg Eppendorf, Dept Med 1, D-20246 Hamburg, Germany

[2] Univ Hosp Rouen, Dept Biostat, Rouen, France

[3] Hop Paul Brousse, Ctr Hepatobiliaire, Paris, France

[4] Queen Elizabeth Hosp, Dept Surg, Birmingham B15 2TH, W Midlands, England

[5] Kings Coll Hosp London, Liver Unit, London, England

[6] Addenbrookes Hosp, Dept Surg, Cambridge CB2 2QQ, England

[7] St Jamess & Seacroft Univ Hosp, Liver Unit, Leeds, W Yorkshire, England

[8] Charite Campus Virchow Klinikum, Klin Allgemein Viszeral & Transplantat Chirurg, Berlin, Germany

[9] Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, D-30623 Hannover, Germany

[10] Univ Groningen Hosp, Dept Surg, Groningen, Netherlands

[11] Univ Klinikum Essen, Klin Allgemeine & Transplantat Chirurg, Essen, Germany

[12] St Vincents Univ Hosp, Liver Transplant Unit, Dublin 4, Ireland

[13] Univ Edinburgh, Royal Infirm, Liver Transplantat Unit, Edinburgh EH3 9YW, Midlothian, Scotland

[14] Sahlgrens Univ Hosp, Dept Surg, Gothenburg, Sweden

[15] Huddinge Univ Hosp, Dept Transplantat Surg, S-14186 Huddinge, Sweden

[16] Univ Med Ctr Hamburg Eppendorf, Dept Hepatobiliary & Transplantat Surg, Hamburg, Germany

[17] Inst Clin & Expt Med, Transplant Ctr, Prague, Czech Republic

[18] Med Univ Warsaw, Dept Gen Transplant & Liver Surg, Warsaw, Poland

[19] Univ Med Ctr Rotterdam, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands

[20] Univ Hosp, Rikshosp, Div Surg, Sect Transplantat,Dept Med, Oslo, Norway

[21] Ege Univ, Sch Med, Dept Surg, Div Hepatobiliary & Liver Transplantat, Izmir, Turkey

[22] Royal Free Hosp, Liver Transplantat Unit, London NW3 2QG, England

[23] Univ Hosp, Dept Surg & Gastroenterol Sci, Padua, Italy

[24] Ghent Univ Hosp, Ctr Dis Liver & Biliary Tract, Dept Surg, B-9000 Ghent, Belgium

来源：

LIVER TRANSPLANTATION | 2010年 / 16卷 / 04期

关键词：

RECURRENCE; DISEASE; PROGNOSIS; SURVIVAL; CRITERIA; IMPACT;

D O I：

10.1002/lt.22018

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The principal aim of this study was to compare the probability of and potential risk factors for death and graft loss after primary adult and pediatric liver transplantation in patients undergoing transplantation for autoimmune hepatitis (AIH) to those in patients undergoing transplantation for primary biliary cirrhosis (PBC; used as the reference group) or alcoholic cirrhosis (used as an example of a nonautoimmune liver disease). The 5-year survival of patients undergoing transplantation for AIH (n = 827) was 0.73 [95% confidence interval (CI) = 0.67-0.77]. This was similar to that of patients undergoing transplantation for alcoholic cirrhosis (0.74, 95% CI = 0.72-0.76, n = 6424) but significantly worse than that of patients undergoing transplantation for PBC (0.83, 95% CI = 0.80-0.85, n = 1588). Fatal infectious complications occurred at an increased rate in patients with AIH (hazard ratio = 1.8, P = 0.002 with PBC as the reference). The outcome of pediatric AIH patients was similar to that of adult patients undergoing transplantation up to the age of 50 years. However, the survival of AIH patients undergoing transplantation beyond the age of 50 years (0.61 at 5 years, 95% CI = 0.51-0.70) was significantly reduced in comparison with the survival of young adult AIH patients (0.78 at 18-34 years, 95% CI = 0.70-0.86) and in comparison with the survival of patients of the same age group with PBC or alcoholic cirrhosis. In conclusion, age significantly affects patient survival after liver transplantation for AN. The increased risk of dying of infectious complications in the early postoperative period, especially above the age of 50 years, should be acknowledged in the management of AIH patients with advanced-stage liver disease who are listed for liver transplantation. It should be noted that not all risk factors relevant to patient and graft survival could be analyzed with the European Liver Transplant Registry database. Liver Transpl 16:461-469, 2010. (C) 2010 AASLD.

引用

页码：461 / 469

页数：9

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