原文是英文的，在最下面，大致是讲比较了两组病人，一组是60岁以上，另外一组是18-59岁的，移植的原因都是良性病（丙肝，肝硬化，胆管炎等），最初几年的存活率差不多，但长期来说，5年存活率第一组是52%,第二组是75%；10年的话第一组是35%，第二组是60%。导致第一组死亡的主要原因是恶性肿瘤，第二组的主因是感染并发症。
我有个疑问，既然做移植的病人都是因为良性病做的手术，为什么年长的病人有一部分最后都得了恶性肿瘤。还有就是年轻人很大一部分死因都因为感染，这也太可惜了，问问大家，想这种得恶性肿瘤和感染应该都是可以避免的吧？尤其是后者，大家日常生活中还是要注意这些方面。
Long-Term Results of Liver Transplantation in Patients 60 Years of
Age and Older
Background. Advances in perioperative care and immunosuppression have enabled clinicians to broaden the
indications for organ transplantation. Advanced age is no longer
considered a contraindication to transplantation at most centers.
Although short-term studies of elderly liver transplant recipients have
demonstrated that the incidence of complications and overall patient
survival are similar to those of younger adults, transplant
center-specific, long-term data are not available.
Methods. From August of 1984 to September of 1997, 91
patients 60 years of age or older received primary liver transplants at
the University of Wisconsin, Madison. This group of patients was
compared with a group of younger adults (n=387) ranging in age from 18
to 59 years who received primary liver transplants during the same
period. The most common indications for transplantation in both groups
were Laennec's cirrhosis, hepatitis C, primary biliary cirrhosis,
primary sclerosing cholangitis, and cryptogenic cirrhosis. There was no
difference in the preoperative severity of illness between the groups.
Results. The length of hospitalization was the same
for both groups, and there were no significant differences in the
incidence of rejection, infection (surgical or opportunistic), repeat
operation, readmission, or repeat transplantation between the groups.
The only significant difference identified between the groups was
long-term survival. Five-year patient survival was 52% in the older
group and 75% in the younger group (P <0.05).
Ten-year patient survival was 35% in the older group and 60% in the
younger group (P <0.05). The most common cause of
late mortality in elderly liver recipients was malignancy (35.0%),
whereas most of the young adult deaths were the result of infectious
complications (24.2%).
Conclusion. Although older recipients at this center
did as well as younger recipients in the early years after liver
transplantation, long-term survival results were not as encouraging.
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发表于 2010-3-18 01:06:58
