Long-Term Outcomes of Simultaneous Liver-Kidney Transplant Patients with Hepatitis B Compared to with Liver Transplant Alone
| Autor: | Tongyi Men, Ming-Qi Fan, Tonghai Xing, Lin Zhong, Yun-Peng Wang, Hao Li, Junwei Fan, Zhihai Peng |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 030230 surgery Liver transplantation medicine.disease_cause Gastroenterology Organ transplantation 03 medical and health sciences 0302 clinical medicine Postoperative Complications Recurrence Risk Factors Clinical Research Internal medicine Cause of Death Preoperative Care medicine Humans Rifle Survival rate Kidney transplantation Survival analysis Hepatitis B virus Postoperative Care business.industry General Medicine Hepatitis B Middle Aged medicine.disease Prognosis Kidney Transplantation Survival Analysis Surgery Liver Transplantation Treatment Outcome Multivariate Analysis 030211 gastroenterology & hepatology Female business |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| Popis: | Background The number and survival rate of simultaneous liver-kidney transplant (SLKT) recipients have increased dramatically since 2002. However, the long-term effectiveness of SLKT in patients with hepatitis B is unknown. Material/methods Forty-six patients who visited the Organ Transplant Center of the Shanghai First People's Hospital between January 2001 and May 2005 had hepatitis B virus infection and renal failure (any degree), and underwent organ transplantation: 21 patients underwent SLKT and 25 patients underwent liver transplant (LT) alone. Results The 1-, 3-, and 5-year survival rates of SLKT recipients were 90.5%, 81.0%, and 81.0%, respectively. Incidence of acute hepatic allograft rejection between SLKT recipients and LT recipients (33% vs. 16%) did not reach significance (P=0.170). Despite higher infection rate, more prevalent hepatitis B relapse, and longer stay in the intensive care unit, SLKT recipients experienced significantly higher 1-year survival rate (90.5%) compared with LT recipients (60%, P=0.019). Multivariate regression analysis revealed that postoperative renal failure (odds ratio (OR)=48, P=0.003) and Risk/Injury/Failure/Loss/End-stage (RIFLE) stage (OR=8, P=0.012) were independent risk factors for postoperative death after LT. Conclusions SLKT in patients with hepatitis B had higher early-stage infection rate, but had a higher long-term survival rate compared with the LT group. Although the incidence of postoperative hepatitis B relapse in SLKT recipients was higher, timely and reasonable treatment can ensure long-term survival of patients. Worsening RIFLE stage of recipients can predict high mortality when only given LT. SLKT might be a better choice for RIFLE stage 2 or 3 patients than LT alone. |
| Databáze: | OpenAIRE |
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