TY - JOUR
T1 - A comparison of outcomes between liver transplant recipients in China and those in Taiwan
AU - Chen, Teng-Wei
AU - Yu, Chih-Yung
AU - Chu, Heng-Cheng
AU - Chan, De-Chuan
AU - Liao, Guo-Shiou
AU - Hsieh, Chung-Bao
N1 - Export Date: 22 March 2016
通訊地址: Hsieh, C.-B.; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-gong Road, Taipei 114, Taiwan; 電子郵件: [email protected]
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PY - 2013
Y1 - 2013
N2 - Background: The outcome of liver transplantation in Taiwan and overseas has not been compared directly. We investigated differences in outcomes between liver transplant recipients in China and those in Taiwan. Materials and Methods: Ninety-two patients who underwent liver transplantation in China and were subsequently being followed at the Tri- Service General Hospital (TSGH; China group; CG) were compared with 107 patients who received transplants at TSGH (Taiwan group; TG). Donor and recipient characteristics, complications, and survival were analyzed. Survival was calculated using the Kaplan-Meier method, and univariate analysis was tested by the log-rank test. Then, regression analysis was performed using the Cox proportional hazard model. Results: The number of patients with hepatocellular carcinoma (HCC) beyond the Milan and University of California, San Francisco criteria was signifi cantly higher in the CG than in the TG. The rates of HCC recurrence, intrahepatic biliary strictures, and mortality were also higher in the CG than in the TG. Univariate analysis revealed signifi cant differences in 8 parameters between survivors and non-survivors, and Cox regression analysis further identifi ed psychosocial problems, post-transplant de novo malignancy, HCC recurrence, and graft failure as mortality predictors. The overall survival rate was signifi cantly higher in the TG than in the CG, with the former group showing a trend of greater mean survival duration. However, differences in survival were not signifi cant after adjusting for risk factors. Conclusion: The outcomes of patients receiving livers donated after cardiac death may be comparable; however, patients with advanced HCC should not seek transplantation without appropriate pre-transplant tumor treatments. © 2013 JMS.
AB - Background: The outcome of liver transplantation in Taiwan and overseas has not been compared directly. We investigated differences in outcomes between liver transplant recipients in China and those in Taiwan. Materials and Methods: Ninety-two patients who underwent liver transplantation in China and were subsequently being followed at the Tri- Service General Hospital (TSGH; China group; CG) were compared with 107 patients who received transplants at TSGH (Taiwan group; TG). Donor and recipient characteristics, complications, and survival were analyzed. Survival was calculated using the Kaplan-Meier method, and univariate analysis was tested by the log-rank test. Then, regression analysis was performed using the Cox proportional hazard model. Results: The number of patients with hepatocellular carcinoma (HCC) beyond the Milan and University of California, San Francisco criteria was signifi cantly higher in the CG than in the TG. The rates of HCC recurrence, intrahepatic biliary strictures, and mortality were also higher in the CG than in the TG. Univariate analysis revealed signifi cant differences in 8 parameters between survivors and non-survivors, and Cox regression analysis further identifi ed psychosocial problems, post-transplant de novo malignancy, HCC recurrence, and graft failure as mortality predictors. The overall survival rate was signifi cantly higher in the TG than in the CG, with the former group showing a trend of greater mean survival duration. However, differences in survival were not signifi cant after adjusting for risk factors. Conclusion: The outcomes of patients receiving livers donated after cardiac death may be comparable; however, patients with advanced HCC should not seek transplantation without appropriate pre-transplant tumor treatments. © 2013 JMS.
KW - Brain death
KW - Donation after cardiac death
KW - Down-stage therapy
KW - Liver transplantation
KW - Survival
KW - adult
KW - article
KW - bile leakage
KW - cancer recurrence
KW - cerebrovascular accident
KW - China
KW - cholangitis
KW - cholestasis
KW - common bile duct stone
KW - erythrophagocytosis
KW - female
KW - graft failure
KW - hepatitis B
KW - human
KW - liver cell carcinoma
KW - liver transplantation
KW - major clinical study
KW - male
KW - middle aged
KW - mortality
KW - overall survival
KW - risk factor
KW - Taiwan
KW - treatment outcome
U2 - 10.6136/JMS.2013.33(6).311
DO - 10.6136/JMS.2013.33(6).311
M3 - Article
SN - 1011-4564
VL - 33
SP - 311
EP - 319
JO - Journal of Medical Sciences (Taiwan)
JF - Journal of Medical Sciences (Taiwan)
IS - 6
ER -