Preoperative Factors Affecting Graft Survival After ABO-incompatible Adult Liver Transplantation.

IF 5.3 2区医学 Q1 IMMUNOLOGY Transplantation Pub Date : 2024-10-23 DOI:10.1097/TP.0000000000005231

Hyun-Jun Nam, Deok-Gie Kim, Eun-Ki Min, Jae Geun Lee, Dai Hoon Han, Sinyoung Kim, Kyung-A Lee, Gi Hong Choi, Dong Jin Joo, Hyun Ok Kim, Soon Sung Kwon, Myoung Soo Kim

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Abstract

Background: Although ABO-incompatible liver transplantation (ABOi LT) has undergone remarkable progress, the prognostic factors are poorly understood. This study aimed to elucidate the preoperative factors affecting graft survival after ABOi LT.

Methods: Patients who underwent ABOi LT between January 2012 and December 2020 at a single institution in South Korea were retrospectively reviewed. A total of 146 recipients, including 34 patients with graft loss, were analyzed.

Results: In the multivariate Cox proportional hazard model, recipient age (≥55 y; hazard ratio, 2.47; 95% confidence interval, 1.18-5.19; P = 0.017) and donor ABO type (donor A, hazard ratio, 3.12; 95% confidence interval, 1.33-7.33; P = 0.009) were significantly associated with an increased risk of graft loss. The most common cause of graft loss was recipient death due to bacterial infection (15/34, 44.1%). Both recipient age and donor ABO type were associated with an increased risk of recipient death due to bacterial infections. The incidence of complications after ABOi LT, including antibody-mediated rejection and diffuse intrahepatic biliary stricture, did not differ according to recipient age or donor ABO type.

Conclusions: These findings suggest that recipient age and donor ABO type should be considered when preparing for ABOi LT. Careful monitoring and care after transplantation are required for recipients with preoperative risk factors.

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影响 ABO 不相容成人肝移植后移植物存活率的术前因素。

背景：尽管ABO不相容肝移植（ABOi LT）取得了显著进展，但对其预后因素的了解却很少。本研究旨在阐明影响ABOi LT术后移植物存活率的术前因素：方法：回顾性分析2012年1月至2020年12月期间在韩国一家医疗机构接受ABOi LT手术的患者。共分析了146名受者，包括34名移植物丢失患者：在多变量Cox比例危险模型中，受体年龄（≥55岁；危险比，2.47；95%置信区间，1.18-5.19；P = 0.017）和供体ABO类型（供体A，危险比，3.12；95%置信区间，1.33-7.33；P = 0.009）与移植物丢失风险增加显著相关。最常见的移植物丢失原因是受者因细菌感染而死亡（15/34，44.1%）。受体年龄和供体的ABO血型都与细菌感染导致的受体死亡风险增加有关。ABOi LT术后并发症的发生率，包括抗体介导的排斥反应和弥漫性肝内胆管狭窄，与受体年龄或供体ABO类型无关：这些研究结果表明，在准备进行ABOi LT时应考虑受者年龄和供体的ABO血型。结论：这些研究结果表明，在准备 ABOi LT 时应考虑受体年龄和供体的 ABO 类型。对于术前存在风险因素的受体，移植后需要仔细监测和护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation 医学-免疫学

CiteScore

8.50

自引率

11.30%

发文量

1906

审稿时长

1 months

期刊介绍： The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year. Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal. Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed. The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.