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本帖最后由 风雨不动 于 2012-4-14 06:30 编辑
50%以上的肝移植受者能存活20年以上
50%以上的肝移植受者能存活20年以上(2010-10-07 21:01:52)
转载标签: 肝移植吉祥皮宝健康 分类: 吉祥移植时讯
根据美国加州大学洛杉矶分校移植中心的最新研究报告,终末期肝病做过肝移植手术后的病人大部分生存状况良好,约56%的肝移植受者能存活至少20年,而且生活质量明显优于普通慢性肝病患者.(附原文摘要)
Duffy JP, Kao K, Ko CY,et al.Long-term patient outcome and quality of life after liver transplantation: analysis of 20-year survivors. Ann Surg. 2010 Oct;252(4):652-61.
Department of Surgery, Dumont-UCLA Transplant Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Abstract
OBJECTIVE: To evaluate patient survival and allograft function and health-related quality of life (HRQOL) 20 years after orthotopic liver transplantation (LT).
SUMMARY OF BACKGROUND DATA: Although LT is the established treatment of choice for acute and chronic liver failure, allograft function and recipient HRQOL 20 years after LT remain undefined.
METHODS: We performed a prospective, cross-sectional study of LT recipients surviving 20 years or more. Clinical data were reviewed to identify factors associated with 20-year survival. Survivors were directly contacted and offered a survey to assess HRQOL (SF-36; Liver Disease Quality of Life), social support, and cognition (Neuropsychological Impairment Scale). Logistic regression analysis was performed to identify clinical factors influencing HRQOL 20 years after LT.
RESULTS: Between February 1, 1984 and December 31, 1988, a total of 293 patients (179 adults, 114 children) received 348 LTs. Of the 293 patients, 168 (56%) survived for 20 years or more. Actuarial 20-year survival was 52% (patient) and 42% (graft). Factors associated with 20-year survival included recipient age <18 (P = 0.01), nonurgent LT (P = 0.01), no retransplantation (0.02), female gender (0.03), absence of biliary complications (P = 0.04), and short total ischemia time (P = 0.05). Rejection episodes were seen in a greater proportion of 20-year survivors than in nonsurvivors (35% vs. 27%; P = 0.3). Of the 168 survivors, 87 were contacted, and 68 (78%) completed the HRQOL surveys. Compared with the general population, survivors had lower physical scores (P < 0.01) but comparable mental scores on the SF-36. Overall HRQOL was significantly better in 20-year survivors than in patients with chronic liver disease, congestive heart failure, or diabetes. Clinical factors associated with improved post-LT HRQOL were younger age at LT, allograft longevity, and strong social support. More than 90% of pediatric survivors completed high school. After LT, 34% of pediatric recipients married, and 79% remained married at 20 years' follow-up.
CONCLUSIONS: More than 50% of LT recipients survive 20 years, achieve important socioeconomic milestones, and report quality of life superior to patients with liver disease or other chronic conditions. LT is a durable surgery that restores both long-term physiologic and psychologic well-being in patients with end-stage liver disease.
http://blog.sina.com.cn/ilovemyliver
来源:吉祥皮宝的博客。
用网上机器自动翻译的。
杜飞JP,高钾、柯CY,罗卓荆。长期患者预后和生活质量的肝脏移植后:分析20年的幸存者。安Surg. 2010年10月;(4):652-61 252。
移植外科学系Dumont-UCLA中心,大卫乙肝时有必要医学院在加州大学洛杉矶分校,洛杉矶、钙、美国。
文摘
摘要目的:评价病人的存活率和移植肾功能及与健康相关的生活质量(HRQOL)20年原位肝移植(LT)。
背景资料概述:虽然简直是既定的首选治疗方式对急、慢性肝脏衰竭,HRQOL移植肾功能和收件人的肝移植后仍未定义20年。
方法:我们进行了一项前瞻性、对比研究肝移植受者幸存的20年或更久。临床资料进行审查,以确认相关因素的生存拥有20年。幸存者,提供了直接挂钩SF-36 HRQOL调查评估;肝病(生活质量)、社会支持与认知神经心理学障碍(规模)。逻辑式回归分析确定影响因素进行临床肝移植后HRQOL 20年。
结果:在2月1日起,1984年和1988年12月31日,共有293例(179个成年人,114儿童)收到348的合理性。病人的293、168(56%)幸存了20年或更久。精算20年生存率为52%(病人)和42%(植)。相关因素包括年龄拥有20年存活率接收者< 18(P = 0.01),nonurgent LT(P = 0.01),没有再移植(0.02),女性性别(0.03)、无胆道并发症(P = 0.04),总缺血时间短(P = 0.05)。排斥反应被认为在更大的比例要比在20年(35% nonsurvivors幸存者和27% = 0.3)。在168个幸存者,87的家乐福联络,68(78%)完成了HRQOL调查。与普通人群相比,幸存者得到较低的物理成绩(P < 0.01),而在SF-36可比心理的分数。整体HRQOL效果明显好于患者幸存者比20慢性肝病、充血性心力衰竭,或糖尿病。用改进后的临床相关因素在更年轻的时候HRQOL同种异体肝移植时的年龄,具有较强的社会支持长寿。超过90%的儿童幸存者完成高中学业。肝移植后,34%的儿童受者结婚成家,79%保持在20年的随访。
结论:肝移植受者超过50%的生存的20年中,实现社会经济的里程碑,并报告重要的生活质量优于患者肝脏疾病和其他慢性疾病。肝移植手术是一种耐用,能恢复生理及心理健康和长期终末期肝病患者中
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