供体年龄对肝细胞癌患者肝移植结局的影响：SRTR数据库分析

StephenW

Impact of donor age on liver transplant outcomes in patients with hepatocellular carcinoma: analysis of the SRTR database
Jie Zhou  1   2   3   4 , Zhichao Huang  1 , Zheng Chen  1 , Fangshen Xu  1 , Rongliang Tong  1   2   3   4 , Shusen Zheng  5   6   7   8
Affiliations
Affiliations

    1
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China.
    2
    NHC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China.
    3
    Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences (2019RU019), Hangzhou, China.
    4
    Key Laboratory of Organ Transplantation, Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, 310003, Zhejiang Province, China.
    5
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China. [email protected].
    6
    NHC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China. [email protected].
    7
    Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences (2019RU019), Hangzhou, China. [email protected].
    8
    Key Laboratory of Organ Transplantation, Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, 310003, Zhejiang Province, China. [email protected].

    PMID: 33931011 DOI: 10.1186/s12876-021-01786-6

Abstract

Background: Donor age is an important predictor for liver transplant recipients. Studies have not fully explored its impact on transplant outcomes in hepatocellular carcinoma (HCC) patients as well as its involvement in tumor recurrence.

Methods: HCC patients who received liver transplants during 2010-2017 from the Scientific Registry of Transplant Recipients database were included. The recipients were divided into four groups based on donor age: I (≤ 34 years), II (35-49 years), III (50-64 years), and IV (≥ 65 years). Transplant outcomes, including the overall survival (OS), tumor recurrence, and risks, were evaluated.

Results: A total of 13,276 HCC recipients were included in this study. Statistical significant differences were observed in OS among the four groups. The best 5-year survival was 76.0% in group I, followed by 73.5% in group II, 72.8% in group III, and 69.2% in group IV (P < 0.001). However, the liver-specific survival did not differ among these groups (P = 0.260). Donor age was found to be the independent predictor of OS after adjusting for other variables (P < 0.001, ref. group I; 1.087 (0.979-1.208) for group II, P = 0.119; 1.124 (1.015-1.246) for group III, P = 0.025; 1.395 (1.215-1.602) for group IV, P < 0.001). In subgroup analysis, OS was significantly different in recipients with hepatitis C virus (HCV), but there was no significant difference for recipients with hepatitis B virus (HBV), alcoholic liver diseases and nonalcoholic steatohepatitis (NASH). The post-transplant cumulative tumor recurrence rates were similar among the four groups (P = 0.382).

Conclusions: Older donor age was associated with decreased OS but not liver-specific survival as well as post-transplant tumor recurrence in HCC recipients. Donor age also had different effects in patients with different underlying liver diseases.

Keywords: Donor age; Hepatocellular carcinoma; Liver transplantation; Outcome; SRTR.

StephenW

供体年龄对肝细胞癌患者肝移植结局的影响：SRTR数据库分析
周杰1 2 3 4，黄志超1，郑铮1，徐方深1，童荣亮1 2 3 4，郑树森5 6 7 8
隶属关系
隶属关系

    1个
    浙江大学医学院附属第一医院肝胆胰外科，外科，杭州
    2个
    NHC混合多器官移植重点实验室，杭州，中国。
    3
    中国医学科学院肝胆胰腺癌协同诊治研究室，器官移植诊治重点实验室（2019RU019），杭州
    4
    肝胆疾病诊治研究中心，器官移植重点实验室，浙江杭州310003。
    5
    浙江大学医学院附属第一医院肝胆胰外科，外科，杭州[email protected]。
    6
    NHC混合多器官移植重点实验室，杭州，中国。 [email protected]。
    7
    中国医学科学院肝胆胰腺癌协同诊治研究室，器官移植诊治重点实验室（2019RU019），杭州[email protected]。
    8
    肝胆疾病诊治研究中心，器官移植重点实验室，浙江杭州310003。 [email protected]。

    PMID：33931011 DOI：10.1186 / s12876-021-01786-6

抽象的

背景：供体年龄是肝移植受者的重要预测指标。研究尚未完全探讨其对肝细胞癌（HCC）患者移植结局的影响以及其是否参与肿瘤复发。

方法：纳入2010-2017年从Science Registry of Transplant Recipients数据库中接受肝移植的HCC患者。根据捐赠者年龄将接受者分为四组：I（≤34岁），II（35-49岁），III（50-64岁）和IV（≥65岁）。评估移植结果，包括总生存期（OS），肿瘤复发和风险。

结果：本研究共纳入13276名HCC接受者。在四组中观察到OS的统计显着差异。 I组的最佳5年生存率是76.0％，然后是II组的73.5％，III组的72.8％和IV组的69.2％（P <0.001）。但是，这些组之间的肝特异性存活率没有差异（P = 0.260）。在调整其他变量后，发现供体年龄是OS的独立预测因子（P <0.001，参考I组； II组为1.087（0.979-1.208），P = 0.119； III组为1.124（1.015-1.246）， P = 0.025； IV组为1.395（1.215-1.602），P <0.001）。在亚组分析中，丙型肝炎病毒（HCV）接受者的OS显着不同，但乙型肝炎病毒（HBV），酒精性肝病和非酒精性脂肪性肝炎（NASH）的接受者没有显着差异。四组之间的移植后累积肿瘤复发率相似（P = 0.382）。

结论：供者年龄较大与肝癌患者OS降低有关，但与肝特异性存活率以及移植后肿瘤复发无关。捐助者年龄在患有不同基础肝病的患者中也有不同的影响。

关键字：供体年龄；肝细胞癌；肝移植；结果; SRTR。

StephenW

https://bmcgastroenterol.biomedc ... 876-021-01786-6.pdf