Abstract:

 Objective To investigate the influence of donor diabetes on the overall prognosis of patients with acute-chronic liver failure （ACLF） after liver transplantation. Methods A retrospective study was conducted in 839 ACLF patients who received liver transplantation from January 1，2013 to December 31，2013 in Scientific Registry of Transplant Recipients （SRTR） database. Then， the recipients were divided into two groups according to whether they used diabetic donors （93 cases were in DM group，746 cases were in non-DM group）. Donor and recipient baseline characteristics were compared between two groups， and overall survival rates were compared according to different recipient ACLF grades. Univariate and multivariable analysis were further used. Results The overall survival rates were comparable in patients with ACLF1 and ACLF2. However， in patients with ACLF3， the 1，3，5-year overall survival rates were 84.3%，78.3%，72.4% in the non-DM group，it was significantly better than that in the DM group， which were 70.4%，55.6%，51.9%， respectively （P ＝ 0.016）. It showed statistically significant differences in ACLF3. In multivariateanalysis， the age of the recipient （P ＝ 0.001）and the diabetes of the donor （P ＝ 0.007） were independent predictors for post-transplant overall survival for patients with ACLF3. Conclusion In patients with ACLF3， donor diabetes is anindependent predictor for inferior overall survival after liver transplantation. 

Key words:

Acute-chronic liver failure； , Donor diabetes； , Liver transplantation； , Prognosis

摘要：

目的 探讨供体糖尿病对慢加急性肝衰竭（acute-chronic liver failure，ACLF）患者肝移植预后的影响。方法 回顾性分析了美国移植受体科学注册中心（Scientific Registry of Transplant Recipients，SRTR）2013 年 1 月 1 日— 2013 年 12 月 31 日接受肝移植的 ACLF 患者 839 例，按照供体是否有糖尿病分成 2 组，其中糖尿病供体组 93 例，非糖尿病供体组 746 例。我们对两组间受体和供体的基本临床信息进行比较，同时比较不同 ACLF 分级中肝移植受体的总体生存率，并进一步行单因素分析和多因素分析。结果 在ACLF1 和 ACLF2 受体中，糖尿病供体组和非糖尿病供体组的总体存活率没有显著性差异。在 ACLF3 受体中，非糖尿病供体组的 1、3、5 年的总体生存率分别是 84.3%、78.3%、72.4%，糖尿病供体组的 1、3、5 年 总体生存率分别是 70.4%、55.6%、51.9%，两组的总体生存率有显著差异（P ＝ 0.016）。在多因素分析中，受者年龄（P ＝ 0.001）和供者糖尿病（P ＝ 0.007）是 ACLF3 受体肝移植后总体存活率的独立预测因子。结论 ACLF3 患者中，供体糖尿病是肝移植术后不良预后的独立预测因子。 

关键词:

慢加急性肝衰竭 , 供体糖尿病 , 肝移植 , 预后