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Long-term results of liver transplantation for polycystic liver disease: Single-center experience in China

机译:多囊性肝病肝移植的长期结果:中国的单中心经验

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摘要

The aim of the present study was to explore the indications for and safety of orthotopic liver transplantation for polycystic liver disease (PLD). Orthotopic liver transplantation in 11 patients with PLD between May 2004 and September 2013 was retrospectively analyzed. Patient epidemiological, clinical and follow-up data were collected. The survival rate was calculated using the Kaplan-Meier method. Over the 10-year period, 11 patients received orthotopic liver transplantation (n=9) and combined liver-kidney transplantation (n=2) for PLD. The recipients' median age was 56 years [(interquartile range (IQR), 52–57 years], and 7 of the patients (63.6%) were classified as having Gigot type II PLD and 4 (36.4%) as having Gigot type III. A total of 8 (72.7%) patients had a severely decreased quality of life (Eastern Cooperative Oncology Group performance status score, ≥3). Only 3 cases (27.3%) were of Class C stage. The mean hospitalization duration was 45.4±15.3 days and the mean length of stay at the intensive care unit was 4.1±1.9 days. The peri-operative mortality was 18.2% and the morbidity was 54.5%. The median follow-up period was 111 months (IQR, 33–132 months). A total of 2 patients died of severe complications after combined liver-kidney transplantation. Furthermore, 1 patient died of ischemia cholangitis during the follow-up period. The actuarial 1-, 5- and 10-year survival rate during the follow-up period was 81.8, 81.8 and 65.5%, respectively. The mean physical component summary score was 87.1±6.9 and the mean mental component summary score was 81.5±6.4. In conclusion, liver transplantation is the only curative procedure for PLD, and the present study indicated that it is relatively and safe and leads to good long-term prognosis and high quality of life. Based on our experience and results, liver transplantation is a primary option for cases of PLD with progressive or advanced symptomatic disease where previous other forms of therapy to palliate symptoms have been insufficient.
机译:本研究的目的是探讨多囊性肝病(PLD)的原位肝移植的适应症和安全性。回顾性分析2004年5月至2013年9月间11例PLD患者的原位肝移植。收集患者的流行病学,临床和随访数据。使用Kaplan-Meier方法计算存活率。在10年期间,有11例患者接受了原位肝移植(n = 9)和肝肾联合移植(n = 2)进行PLD。接受者的中位年龄为56岁((四分位间距(IQR),52-57岁),其中7名患者(63.6%)被归类为Gigot II型PLD,4名患者(36.4%)被归类为Gigot III型。共有8(72.7%)名患者的生活质量严重下降(东方合作肿瘤小组的工作状态评分,≥3),只有3例(27.3%)为C级,平均住院时间为45.4±重症监护病房15.3天,平均住院时间为4.1±1.9天,围手术期死亡率为18.2%,发病率为54.5%,中位随访时间为111个月(IQR,33-132个月) )。肝肾联合移植后,共有2例患者死于严重并发症,此外,在随访期间,有1例患者死于缺血性胆管炎,其术后1、5和10年的精算生存率如下:上升期分别为81.8、81.8和65.5%,平均身体成分总分是87.1±6.9,平均水平是总成分总分是81.5±6.4。总之,肝移植是PLD唯一的治疗方法,本研究表明它是相对安全的,可长期预后良好,生活质量高。根据我们的经验和结果,肝移植是进行性或晚期症状性疾病的PLD病例的主要选择,以前的其他形式的缓解姑息症状的治疗方法不足。

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