原著・報告・記録(44行)/P156~169_報告 肝移植症例登録
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1 156 Vol. 50, No. 23 Liver Transplantation in Japan Registry by the Japanese Liver Transplantation Society The Japanese Liver Transplantation Society Summary As of December 31, 2014, a total of 7,937 liver transplants have been performed in 67 institutions in Japan. This total included 7,673 living-donor transplants and 264 cadaveric-donor transplants261 from heart-beating donor and 3 from non-heart-beating donor. The annual total of liver transplants in 2014 increased to 463, from 408, in The number of liver transplants from living-donor increased to 418, from 369, whereas the number of liver transplants from heart-beating cadaveric donor did not change significantly. The most frequent indication was cholestatic disease, followed by neoplastic disease. As for the graft liver in living-donor cases, right-lobe graft was the most popular35%. Patient survival following transplantation from heart-beating donor1, 87.1%; 3, 83.9%; 5, 83.1%; 10, 77.4%; 15, 77.4%was similar to those from living-donors1, 84.1%; 3, 79.9%; 5, 77.4%; 10, 72.2%; 15, 68.3%; 20, 66.6%. Graft survival was very much the same as patient survival. As for ABO-incompatible transplantation, new strategies including portal vein infusion and rituximab prophylaxis have been improving the prognosis in adults as well as in children older than 3 s. Japanese Liver Transplantation Society, registry, cadaveric liver transplantation, living-donor liver transplantation, prognosis FAX 1 / web Kaplan-Meier
2 157 logrank test , Living-donor Transplantation 7,673 Cadaveric Transplantation 264 Heart Beating Donor 261 Non-heart Beating Donor 3 Primary Transplantation 7,682 Retransplantation 242 Third Transplantation , ,673 7, , Adults: 18 s Year Living-donor Cadaveric Total Total , , , ,150
3 158 Vol. 50, No C / 10 6 / 4 B NASH cryptogenic cirrhosis solid pseudopapillary tumor 1 9epithelioid hemangioendothelioma Caroli 2 1B 1cryptogenic cirrhosis NASH DNA Dubin-Johnson Protein C GVHD 5 4 SCID monosegment graft graft graft graft graft graft graft graft graft split 31 2 dual graft 2 split dual graft 2 7, , split 6B ,672 95% 44%23%18% 10% dual graft 7, ,675 3 split
4 159 Age Total Male Female Total Age Total Male , ,661 Female 1, ,012 Total 2, ,985 1, ,673 Age of Recipient 18 y.o. 18 y.o. Total Cholestatic Diseases Biliary Atresia Primary Sclerosing Cholangitis Primary Biliary Cirrhosis Alagille Syndrome Caroli Disease Hepatocellular Diseases HCV HBV Alcoholic AIH NASH Cryptogenic Cirrhosis Vascular Diseases Budd-Chiari Neoplastic Diseases Hepatocellular Carcinoma Hemangioma Acute Liver Failure HBV Drug-induced Autoimmune Hepatitis ViralHBV Hemochromatosis Unknown Metabolic Diseases Wilson Disease Citrullinemia OTC Deficiency Familial Amyloid Polyneuropathy Glycogen Storage Disease Others Polycystic Liver Others Total
5 160 Vol. 50, No. 23 Age of Recipient 18 y.o. 18 y.o. Total Cholestatic Diseases 1,953 1,068 3,021 Biliary Atresia 1, ,985 Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Alagille Syndrome Byler s Disease Caroli Disease Congenital Bile Duct Dilatation Others Hepatocellular Diseases 45 1,429 1,474 HCV HBV Alcoholic Autoimmune Hepatitis NASH Cryptogenic Cirrhosis Others Vascular Diseases Budd-Chiari Syndrome Congenital Absence of Portal Vein Others Neoplastic Diseases 103 1,528 1,631 Hepatocellular Carcinoma 8 1,488 1,496 HCV HBV Alcoholic Primary Biliary Cirrhosis NASH Others Hepatoblastoma Liver Metastatis Hemangioma Others Acute Liver Failure HBV Autoimmune Hepatitis Drug-induced ViralHBV Unknown Others Metabolic Diseases Wilson Disease Familial Amyloid Polyneuropathy OTC Deficiency Citrullinemia Glycogen Storage Disease Methylmalonic Acidemia Primary Hyperoxaluria CPS deficiency Tyrosinemia Propionic acidemia Others Others Total 2,653 4,823 7,476
6 161 Year Total HCV HBV Alcohol AIH NASH Cryptogenic Others Total ,475 Age of Recipient 18 y.o. 18 y.o. Total Monosegment Lateral Segment Left Lobe Left Lobe + Caudate Lobe Right Lobe Right Trisegment Whole Liver Age of Recipient Total 18 y.o. 18 y.o. Monosegment Lateral Segment 1, ,893 Posterior Segment Left Lobe ,520 Left Lobe + Caudate Lobe 107 1,163 1,270 Right Lobe 85 2,622 2,707 Right Trisegment Whole LiverDomino Dual GraftLeft + Right Lobes ,751 4,922 7,673 Age Unknown Total Male Female Unknown Total Age Total Male ,202 1, ,163 Female , ,512 Total ,932 2,666 1,562 1, ,675 7,672 split FAP ABO dual graft 1
7 162 Vol. 50, No y.o. Age of Recipient 18 y.o. Mother 1, ,701 Father 1, ,419 Son 0 1,494 1,494 Daughter Brother Sister Nephew Grandmother Aunt Cousin 3 Male 2, Female 1 29 Male 24, Female 5 32 Uncle Grandfather Niece Father s cousin 2 Male 1, Female Mother s cousin 0 1 Female 1 Grandson Cousin s son Cousin s daughter Wife Husband Brother-in-law Son-in-law Sister-in-law Father-in-law Daughter-in-law Nephew-in-law Mother-in-law Grandfather-in-law Uncle-in-law Common-law husband Common-law wife Friend 0 1 Female 1 Domino 2 Male 1, Female 1 44 Male 22, Female Total 2,751 4,924 7,675 Year Total 18 s s Total
8 163 ABO ABO 2 7, ,672 dual graft 1 ABO 2 ABO 10.3% 14.0% ABO 10 1/ p Age of Recipient Total 18 y.o. 18 y.o. Identical 1,810 3,315 5,125 Compatible 557 1,101 1,658 Incompatible ,751 4,921 7, / p p p p data not shown 46 p p p0.0266hcv HBV p p n % %epithelioid hemangioendothelioman % % p Year Total 18 s s Total n 1 Patient Survival% n 1 Graft Survival% Cadaveric Donor Heart-beating Non-heart-beating Living Donor 7, ,
9 164 Vol. 50, No. 23 n 1 Cumulative Survival% Primary or Primary Retransplant Re- and Re-re-transplantation Recipient Age Indication Primary Cholestatic Disease Biliary Atresia Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Hepatocellular Disease HCV HBV Neoplastic Disease HCC Acute Liver Failure HBV Unknown Metabolic Disease
10 165 n 1 Cumulative Survival% Primary or Primary 7, Retransplant Re- and Re-re-transplantation Recipient Gender Male 3, Female 4, Recipient Age 18 2, , Indication primary , , , Cholestatic Disease 3, Biliary Atresia 1, Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Alagille Syndrome Byler s Disease Caroli Disease Congenital Bile Duct Dilatation Hepatocellular Disease 1, HCV HBV Alcoholic Autoimmune Hepatitis NASH Cryptogenic Cirrhosis Vascular Disease Budd-Chiari Congenital Absence of Portal Vein Neoplastic Disease 1, HCC 1, Hepatoblastoma Liver Metastasis Hemangioma Acute Liver Failure HBV Autoimmune Hepatitis Drug-induced ViralHBV Unknown Metabolic Disease Wilson Disease Familial Amyloid Polyneuropathy OTC Deficiency Citrullinemia Glycogen Storage Diseases Methylmalonic Acidemia Primary Hyperoxaluria CPS Deficiency Tyrosinemia Propionic Acidemia
11 166 Vol. 50, No. 23 n 1 Cumulative Survival% Donor Age , , , , Domino Domino Non-Domino 7, ABO Compatibility Identical 5, Compatible 1, Incompatible % %3 78.9% % n % GVHDn %3 50.0%5 25.0%
12 167 5 ABO data not shown 6 data not shown 710
13 168 Vol. 50, No. 23 p0.0001hcv p HCV n %3 49.6%5 38.6% % 66 8 p ABO data not shown 10 ABO p %3 85.3%5 84.7% % % %3 72.2%5 69.7% % % %3 66.2%5 63.9% % % p ABO rituximab % % %3 56.5%5 52.9% % %3 70.1%5 68.1% % p %p
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