34例肝移植患者术后生存影响因素分析

Influencing factors for survival after liver transplantation: a prognostic analysis of 34 cases

目的总结肝移植患者术后生存情况,分析影响肝移植术后长期生存的因素。方法回顾分析2002年9月-2014年8月新疆医科大学第一附属医院完成的34例肝移植病例,统计生存率,分析并发症、死亡原因。生存率估计采用Kaplan-Meier法。结果本组1、3、5年实际生存率达到82.8%、64.4%和50.9%。Child-Pugh A级与B/C级患者1、3和5年生存率比较差异均无统计学意义(P值分别为0.756、0.486、0.261)。尸体肝移植患者与活体肝移植患者术后1、3、5年生存率比较差异均有统计学意义(P值分别为0.01、0.006、0.006)。结论有选择地实施肝移植可以取得良好疗效。肝癌复发、胆道吻合口狭窄、免疫抑制剂副作用是影响本组肝移植患者术后长期生存的因素。

Objective To summarize the survival outcomes of 34 cases of liver transplantation,and analyze the influencing factors for the long- term survival outcomes after liver transplantation. Methods Thirty- four patients who underwent liver transplantation in our hospital from September 2002 to August 2014 were retrospectively analyzed. The survival rates were estimated by the Kaplan- Meier method,and the complications and causes of death were analyzed. Results The 1-,3-,and 5- year overall survival（ OS） rates were 82. 8%,64. 4%,and 50. 9%,respectively. There were no significant differences in the 1-,3-,and 5- year OS rates between Child- Pugh class A and B / C patients（ P = 0. 756; P = 0. 486; P = 0. 261）. There were significant differences in the 1-,3-,and 5- year OS rates between patients undergoing deceased donor liver transplantation and live donor liver transplantation（ P = 0. 01; P = 0. 006; P = 0. 006）. Conclusion Elective liver transplantation can achieve a good clinical outcome. Recurrent liver cancer,biliary anastomotic strictures,and immunosuppressive side effects are the influencing factors for the long- term survival outcomes after liver transplantation in this study.