トクシゲ　カツトシ   TOKUSHIGE Katsutoshi   徳重　克年    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	An Analysis of 10,000 Cases of Living Donor Liver Transplantation in Japan: Special Reference to the Graft-Versus-Recipient Weight Ratio and Donor Age
掲載誌名	正式名：Annals of surgery 略　 称：Ann Surg ISSNコード：15281140/00034932
掲載区分	国外
巻・号・頁	279(1),pp.94-103
著者・共著者	EGUCHI Susumu,UMESHITA Koji,SoejimaYuji,EGUCHI Hidetoshi,EGAWA Hiroto,FUKUMOTO Takumi,HAGA Hironori,HASEGAWA Kiyoshi,KASAHARA Mureo,NAGANO Hiroaki,TAKEDA Yasutsugu,TOKUSHIGE Katsutoshi,UEDA Yoshihide,MOCHIDA Satoshi,MATSUSHIMA Hajime,ADACHIi Tomohiko,OHDAN Hideki,
発行年月	2024/01
概要	OBJECTIVE:To analyze 10,000 cases of living donor liver transplantation (LDLT) recipient data to elucidate outcomes with special reference to the graft-versus-recipient weight ratio (GRWR), based on the Japanese Liver Transplantation Society (JLTS) registry.BACKGROUND:The JLTS registry has been accurate and complete in characterizing and following trends in patient characteristics and survival of all patients with LDLT.METHODS:Between November 1989 and August 2021, 10,000 patients underwent LDLT in Japan. The procedures performed during the study period included pediatric liver transplantation (age <18 years, n = 3572) and adult liver transplantation (age ≥18 years, n=6428). Factors related to patient survival (PS) and graft survival (GS) were also analyzed.RESULTS:The GRWR was <0.7, 0.7 to <0.8, 0.8 to <3, 3 to <5, and ≥5 in 0.2%, 2.0%, 61.8%, 31.8%, and 2.6% of pediatric patients and <0.6, 0.6 to <0.7, 0.7 to <0.8, and ≥0.8 in 8.0%, 12.7%, 17.7%, and 61.5% of adult patients, respectively. Among pediatric recipients, the PS rate up to 5 years was significantly better in cases with a GRWR ≤5 than in those with a GRWR >5. When the GRWR and donor age were combined, among adult recipients 50 to 60 years old, the early PS and GS up to 5 years were significantly better in cases with a GRWR ≥0.7, than in those with a GRWR <0.7. (P = 0.02). In adults, a multivariate analysis showed that GRWR <0.6, transplant era (<2011), donor age (>60 years), recipient age (>60 years), model for end-stage liver disease score (≥20), and center volume (<10) were significant prognostic factors for long-term PS.CONCLUSION:Although a satisfactory long-term PS and GS, especially in the recent era (2011-2021), was achieved in the JLTS series, a GRWR ≥5 in pediatric cases and relatively old donors with a GRWR <0.7 in adult cases should be managed with caution.
DOI	10.1097/SLA.0000000000006121
PMID	38112092