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发表于 2003-11-2 19:47
SourceURL:http://www.gastrohep.com/news/news.asp?id=2360
Survival of recipients of liver grafts from donors over 80 years
The use of grafts from older donors is safe for orthotopic liver
transplantation, find doctors in the latest issue of Liver Transplantation.
Orthotopic liver transplantation (OLT) using grafts from donors older than
80 years have been reported. However, the long-term outcome of patients
receiving livers from these donors is unknown.
In this study, doctors from Italy evaluated 12 patients who received OLTs
between 1998 and 2003. Donors were over 80 years. More than a years worth
of follow-up data were available.
The team found that hepatic insufficiency caused by hepatitis C virus
(HCV)-related cirrhosis occurred in 42% of patients, and non-HCV-related
diseases in 58%.
Transplantation was uneventful in all cases.
Liver Transplantation
All donors had normal liver function, hemodynamic stability, and no
parenchymal alterations.
The doctors found that OLT was uneventful in all cases, and no late
vascular complications occurred.
One patient died 3 years after OLT for causes unrelated to hepatic
dysfunction.
The team calculated 2 and 3-year actuarial survival rates as 100% and 75%,
respectively.
All HCV-positive patients developed hepatitis recurrence requiring
antiviral treatment.
However, non-HCV-positive patients had well-preserved liver function
throughout the observation period.
By the end of follow-up, the team observed no clinical hepatic decompensation.
Biochemical signs of recurrent disease were noted in 3 patients.
Dr Matteo Cescon's team concluded, "Use of grafts for OLT from donors older
than 80 years is safe because of their potentially normal functional
recovery".
"A selection among available organs is mandatory to minimize other risk
factors for poor outcome".
"Long-term patient and graft survival seem to be achievable, but the high
rate and rapidity of HCV reinfection remain a major concern for HCV+
patients".
Liver Transpl 2003; 9: 1174-80
31 October 2003
"Enlightenment does not come 'by imagining figures of light but by making
the darkness conscious.'" (Jung)
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