Gastroenterology: 严重酒精性肝炎患者早期肝移植的结果分析

2018-08-31 MedSci MedSci原创

美国酒精性肝炎早期肝移植联盟是由来自8个联合器官共享区域的12个中心组成,本项研究则根据其数据库数据研究了严重酒精性肝炎(AH)患者进行早期肝移植(LT)的预后结局。

背景与目的
美国酒精性肝炎早期肝移植联盟是由来自8个联合器官共享区域的12个中心组成,本项研究则根据其数据库数据研究了严重酒精性肝炎(AH)患者进行早期肝移植(LT)的预后结局。

方法
这项一项回顾性研究,入组的患者为诊断为严重AH,并且没有肝脏疾病或处于AH发作期的患者,随访时间为2006年至2017年。研究人员收集了患者有关基线特征,LT前的饮酒水平,疾病进程和治疗以及LT结果的数据。戒酒的间隔被定义为最后一次饮酒与LT日期之间的时间。主要观察结局是LT后的生存情况。

结果
在接受肝移植的147例AH患者中,LT前治疗时间的中位数为55天;AH患者中54%接受糖皮质激素治疗,患者Lille评分中位数为0.82,终末期肝病模型评分为39分。术后LT患者存活率百分比为94%(95%[CI] ):89%-97%)和3年时84%(95%CI:75%-90%)。患者接受LT后,72%戒断饮酒,11%持续饮酒。LT后任何酒精使用的累积发生率在1年时为25%(95%CI:18%-34%),3年时为34%(95%CI:25%-44%)。LT后持续饮酒的累积发生率为1年时的10%(95%CI:6%-18%)和3年时的17%(95%CI:10%-27%),多变量回归分析显示LT后持续饮酒与死亡风险增加有关(OR:4.59;P= .01)。

结论
在这项对147名接受早期LT治疗严重AH的患者的回顾性分析中,研究人员发现大多数患者可以存活1年(94%)以及3年(84%)。LT后持续饮酒很少见但与死亡率增加有关。

原始出处:

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    2019-07-06 许安
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