Indications for liver transplantation (LT) vary across age groups. We identified predictors of outcomes for teenage LT waitlisted candidates and recipients in the United States from 2008 to 2022. The Scientific Registry of Transplant Recipients 2008–2022 provided data (clinical, sociodemographic, indications for LT, outcomes) for all teenagers (13–19 years) waitlisted for LT in the United States. Sociodemographic and clinical characteristics, including primary listing diagnoses, were evaluated and compared by age group (13–16 vs. 17–19 years) among waitlisted teenage candidates. There were 2,813 teenage LT candidates listed between 2008 and 2022. The most common LT indication was acute liver disease (23.5%), followed by biliary atresia or hypoplasia (11.9%), autoimmune hepatitis (11.1%), and primary sclerosing cholangitis (9.7%). In contrast, chronic viral hepatitis, metabolic dysfunction-associated steatotic liver disease, and alcohol-related liver disease (the most common indications in adults) did not exceed 1% each; 2.8% had hepatocellular carcinoma. Excluding the two most recent years, 67.2% of candidates received a transplant; mean time to transplant was 217.0 days (standard deviation 371.6). Independent predictors of receiving a transplant were a more recent calendar year, younger age, higher model for end-stage liver disease score, and an acute liver disease diagnosis (all < .05). Among the LT group, 3-year survival was 90%, with an improving survival trend. Higher post-transplant mortality was associated with earlier years of transplantation, older age, having Medicaid, being retransplanted, and having hepatocellular carcinoma (adjusted hazard ratios >1, all < .05). Indications for LT among US teenagers are different from adults or younger children. There is a trend toward improved post-transplant outcomes.

中文翻译：

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美国青少年肝移植概况


肝移植（LT）的适应症因年龄组的不同而不同。我们确定了 2008 年至 2022 年美国青少年 LT 候补候选人和接受者结果的预测因素。2008-2022 年移植接受者科学登记处提供了所有青少年（13-19 岁）的数据（临床、社会人口统计、LT 适应症、结果）。年）在美国列入 LT 候补名单。按年龄组（13-16 岁与 17-19 岁）对候补青少年候选人的社会人口学和临床特征（包括主要列出诊断）进行评估和比较。 2008 年至 2022 年间，列出了 2,813 名青少年 LT 候选者。最常见的 LT 适应症是急性肝病 (23.5%)，其次是胆道闭锁或发育不全 (11.9%)、自身免疫性肝炎 (11.1%) 和原发性硬化性胆管炎 (9.7%)。 %）。相比之下，慢性病毒性肝炎、代谢功能障碍相关的脂肪性肝病和酒精相关性肝病（成人最常见的适应症）均不超过 1%； 2.8%患有肝细胞癌。排除最近两年，67.2%的候选人接受了移植手术；平均移植时间为 217.0 天（标准差 371.6）。接受移植的独立预测因素包括较近的日历年份、较年轻的年龄、较高的终末期肝病模型评分以及急性肝病诊断（均为 < .05）。 LT组的3年生存率为90%，且生存率有改善趋势。较高的移植后死亡率与移植年龄较早、年龄较大、享受医疗补助、再次移植和患有肝细胞癌有关（调整后的风险比为 >1，全部为 < .05）。美国青少年的 LT 适应症与成人或年幼儿童不同。 有改善移植后结果的趋势。