Volume 11 Issue 1
Jan.  2020
Turn off MathJax
Article Contents
Song Zhanyu, Pan Qi, Yu Yang, et al. Pairing analysis of clinical prognosis between liver transplantation with autoimmune liver disease and viral hepatitis cirrhosis[J]. ORGAN TRANSPLANTATION, 2020, 11(1): 82-86. doi: 10.3969/j.issn.1674-7445.2020.01.013
Citation: Song Zhanyu, Pan Qi, Yu Yang, et al. Pairing analysis of clinical prognosis between liver transplantation with autoimmune liver disease and viral hepatitis cirrhosis[J]. ORGAN TRANSPLANTATION, 2020, 11(1): 82-86. doi: 10.3969/j.issn.1674-7445.2020.01.013

Pairing analysis of clinical prognosis between liver transplantation with autoimmune liver disease and viral hepatitis cirrhosis

doi: 10.3969/j.issn.1674-7445.2020.01.013
More Information
  • Corresponding author: Liu Yongfeng, Email: gdwkkyxx@sina.com
  • Received Date: 2019-10-15
    Available Online: 2021-01-19
  • Publish Date: 2020-01-15
  •   Objective  To analyze the difference and influential factors of clinical prognosis between liver transplantation with autoimmune liver disease (AILD) and viral hepatitis cirrhosis.  Methods  Clinical data of 75 recipients undergoing liver transplantation from January 2002 to January 2017 were retrospectively analyzed. All recipients were divided into the AILD group (n=25) and viral hepatitis cirrhosis group (n=50). The intraoperative conditions of the recipients were observed including warm ischemia time, cold ischemia time, operation time, anhepatic phase and blood transfusion volume. Postoperative complications were observed including severe acute kidney injury (AKI), infection, acute rejection, biliary tract-related complications, vascular-related complications and post transplantation diabetes mellitus (PTDM). The follow-up status were monitored after discharge. The prognostic factors of liver transplant recipients were analyzed.  Results  The warm ischemia time, cold ischemia time, operation time and anhepatic phase did not significantly differ between two groups (all P > 0.05). In the AILD group, the incidence of postoperative acute rejection was remarkably higher, whereas the incidence of postoperative severe AKI was significantly lower than those in the viral hepatitis cirrhosis group (both P < 0.05). The postoperative 1-, 3- and 5-year survival rates in the AILD group was 92%, 87%, and 87%, which did not significantly differ from 88%, 88% and 88% in the viral hepatitis cirrhosis group (all P > 0.05). Univariate analysis showed that age, model for end-stage liver disease (MELD) score, severe AKI, infection and biliary tract-related complications were the influencing factors of clinical prognosis of the recipients (all P < 0.05).  Conclusions  The overall survival prognosis does not significantly differ between the AILD and viral hepatitis cirrhosis groups. Age, MELD score, severe AKI, infection and biliary tract-related complications are the risk factors affecting the clinical prognosis of liver transplantation recipients.

     

  • loading
  • [1]
    谭立明, 吴思凡, 郑葳, 等.自身免疫性肝病合并血管炎患者检测ANCA、IgG4的潜在价值[J].实用医学杂志, 2018, 34(14):2410-2415. DOI: 10.3969/j.issn.1006-5725.2018.14.032.

    TAN LM, WU SF, ZHENG W, et al. Potential value of detection of ANCA and IgG4 in autoimmune liverdisease complicated with vasculitis[J]. J Pract Med, 2018, 34(14):2410-2415.DOI:10.3969/j.issn.1006-5725. 2018.14.032.
    [2]
    ARNDTZ K, HIRSCHFIELD GM. The pathogenesis of autoimmune liver disease[J]. Dig Dis, 2016, 34(4):327-333. DOI: 10.1159/000444471.
    [3]
    邹游, 张磊, 李瑞东, 等.肝移植治疗终末期自身免疫性肝病的预后分析[J].器官移植, 2014, 5(4):222-226. DOI: 10.3969/j.issn.1674-7445.2014.04.006.

    ZOU Y, ZHANG L, LI RD, et al. Prognostic analysis of liver transplantation in treating patients with end-stageautoimmune liver disease[J]. Organ Transplant, 2014, 5(4):222-226. DOI:10.3969/j.issn.1674-7445. 2014.04.006.
    [4]
    帅鸣琪, 耿磊, 严盛, 等.肝移植治疗终末期自身免疫性肝病的预后分析[J].中华器官移植杂志, 2015, 36(8):486-489.DOI: 10.3760/cma.j.issn.0254-1785.2015.08.009.

    SHUAI MQ, GENG L, YAN S, et al. A prognostic analysis of liver transplantation in treating endstage autoimmune liver disease[J]. Chin J Organ Transplant, 2015, 36(8):486-489. DOI: 10.3760/cma.j.issn.0254-1785.2015.08.009.
    [5]
    ZHONG CP, XI ZF, XIA Q. Clinical analysis of liver transplantation in autoimmune liver diseases[J]. Hepatobiliary Pancreat Dis Int, 2018, 17(1):27-31. DOI: 10.1016/j.hbpd.2018.01.001.
    [6]
    中华医学会肝病学分会, 中华医学消化病学分会, 中华医学会感染病学分会.原发性硬化性胆管炎诊断和治疗专家共识(2015)[J].中华传染病杂志, 2016, 34(8):449-458.DOI: 10.3760/cma.j.issn.1000-6680.2016.08.001.

    Branch of Hepatology of Chinese Medical Association, Branch of Gastroenterology of Chinese Medical Association, Branch of Infectious Diseases of Chinese Medical Association. Expert consensus on diagnosis and treatment of primary sclerosing cholangitis (2015)[J]. Chin J Infect Dis, 2016, 34(8):449-458. DOI: 10.3760/cma.j.issn.1000-6680.2016.08.001.
    [7]
    VANDERLOCHT J, VAN DER CRUYS M, STALS F, et al. Multiplex autoantibody detection for autoimmune liver diseases and autoimmune gastritis[J]. J ImmunolMethods, 2017, 448:21-25. DOI: 10.1016/j.jim.2017.05. 003.
    [8]
    SAMUEL D, SANCHEZ-FUEYO A. Immunotherapy in liver transplantation[J]. J Hepatol, 2017, 67(4):874-875. DOI: 10.1016/j.jhep.2017.05.013.
    [9]
    KHWAJA A. KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron Clin Pract, 2012, 120(4):c179-c184. DOI: 10.1159/000339789.
    [10]
    SHARIF A, HECKING M, DE VRIES AP, et al. Proceedings from an international consensus meeting on posttransplantation diabetes mellitus: recommendations and future directions[J]. Am J Transplant, 2014, 14(9):1992-2000. DOI: 10.1111/ajt.12850.
    [11]
    RODRÍGUEZ-PERÁLVAREZ M, RICO-JURI JM, TSOCHATZIS E, et al. Biopsy-proven acute cellular rejection as an efficacy endpoint of randomized trials in liver transplantation: a systematic review and critical appraisal[J]. Transpl Int, 2016, 29(9):961-973. DOI: 10.1111/tri.12737.
    [12]
    DEMETRIS AJ, BELLAMY C, HÜBSCHER SG, et al. 2016 comprehensive update of the banff working group on liver allograft pathology: introduction of antibody-mediated rejection[J]. Am J Transplant, 2016, 16(10):2816-2835. DOI: 10.1111/ajt.13909.
    [13]
    VEERAPPAN A, VANWAGNER LB, MATHEW JM, et al. Low incidence of acute rejection in hepatitis B virus positive liver transplant recipients and the impact of hepatitis B immunoglobulin[J]. Hum Immunol, 2016, 77(4):367-374. DOI: 10.1016/j.humimm.2016.02.009.
    [14]
    DURAND F, FRANCOZ C, ASRANI SK, et al. Acute kidney injury after liver transplantation[J]. Transplantation, 2018, 102(10):1636-1649. DOI: 10.1097/TP.0000000000002305.
    [15]
    UMBRO I, TINTI F, SCALERA I, et al. Acute kidneyinjury and post-reperfusion syndrome in liver transplantation[J]. World J Gastroenterol, 2016, 22(42): 9314-9323. doi: 10.3748/wjg.v22.i42.9314
    [16]
    BARRETO AG, DAHER EF, SILVA JUNIOR GB, et al. Risk factors for acute kidney injury and 30-day mortality after liver transplantation[J]. Ann Hepatol, 2015, 14(5):688-694. doi: 10.1016/S1665-2681(19)30763-X
    [17]
    SENTER-ZAPATA M, KHAN AS, SUBRAMANIAN T, et al. Patient and graft survival: biliary complicationsafter liver transplantation[J]. J Am Coll Surg, 2018, 226(4):484-494. DOI: 10.1016/j.jamcollsurg.2017.12.039.
    [18]
    LAICI C, GAMBERINI L, BARDI T, et al. Early infections in the intensive care unit after liver transplantation-etiology and risk factors: a single-center experience[J]. Transpl Infect Dis, 2018, 20(2):e12834. DOI: 10.1111/tid.12834.
    [19]
    JADLOWIEC CC, TANER T. Liver transplantation: current status and challenges[J]. World J Gastroenterol, 2016, 22(18):4438-4445. DOI: 10.3748/wjg.v22.i18.4438.
    [20]
    LIBERAL R, ZEN Y, MIELI-VERGANI G, et al. Liver transplantation and autoimmune liver diseases[J]. Liver Transpl, 2013, 19(10):1065-1077. DOI: 10.1002/lt.23704.
    [21]
    MONTANO-LOZA AJ, BHANJI RA, WASILENKO S, et al. Systematic review: recurrent autoimmune liver diseases after liver transplantation[J]. Aliment Pharmacol Ther, 2017, 45(4):485-500. DOI: 10.1111/apt.13894.
    [22]
    BOSCH A, DUMORTIER J, MAUCORT-BOULCH D, et al. Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence[J]. J Hepatol, 2015, 63(6):1449-1458. DOI: 10.1016/j.jhep.2015.07.038.
    [23]
    CHARATCHAROENWITTHAYA P, PIMENTEL S, TALWALKAR JA, et al. Long-term survival and impact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantation[J]. Liver Transpl, 2007, 13(9):1236-1245. doi: 10.1002/lt.21124
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(1)

    Article Metrics

    Article views (143) PDF downloads(9) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return