[1]王婷婷,姜英俊,解曼,等.公民逝世后器官捐献供肝移植术后早期肝功能不全的危险因素分析[J].青岛大学医学院学报,2017,53(03):287-290,293.[doi:10.13361/j.qdyxy.201703010]
 WANG Tingting,JIANG Yingjun,XIE Man,et al.RISK FACTORS FOR PRIMARY GRAFT DYSFUNCTION AFTER LIVER TRANSPLANTATION FROM DONATION AFTER CARDIAC DEATH[J].Acta Aacademiae Medicinae Qingdao,2017,53(03):287-290,293.[doi:10.13361/j.qdyxy.201703010]
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公民逝世后器官捐献供肝移植术后早期肝功能不全的危险因素分析()
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《青岛大学医学院学报》[ISSN:1672-4488/CN:37-1356/R]

卷:
第53卷
期数:
2017年03期
页码:
287-290,293
栏目:
出版日期:
2017-08-07

文章信息/Info

Title:
RISK FACTORS FOR PRIMARY GRAFT DYSFUNCTION AFTER LIVER TRANSPLANTATION FROM DONATION AFTER CARDIAC DEATH
文章编号:
1672-4488(2017)03-0287-05
作者:
王婷婷1姜英俊2解曼1孔心涓1饶伟3臧运金3
青岛大学附属医院,山东 青岛 266003 1 消化内科; 2 急诊外科; 3 器官移植中心
Author(s):
WANG Tingting JIANG Yingjun XIE Man KONG Xinjuan RAO Wei ZANG Yunjin
Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
关键词:
肝移植公民逝世后器官捐献肝功能不全危险因素
Keywords:
liver transplantation donation after citizen’s death hepatic insufficiency risk factors
分类号:
R657.3;R575
DOI:
10.13361/j.qdyxy.201703010
文献标志码:
A
摘要:
目的 观察公民逝世后器官捐献(DCD)供肝移植术后早期肝功能不全(PGD)的发生情况,并分析PGD发生的危险因素。
方法 回顾性分析2014年7月—2016年3月于我院器官移植中心行肝移植的42例供受体病人的临床资料,其中供体资料包括性别,年龄,血型,死亡原因,ICU住院时间,脂肪变性的程度,冷缺血时间(CIT),热缺血时间(WIT),术前血丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TB)水平等;受体资料包括性别,年龄,血型,原发病,术前终末期肝病模型(MELD)评分,术中的失血量、输血量、无肝期时间,手术时间,术后ICU住院时间等。对上述因素先进行单因素分析,然后将差异有显著性的因素纳入Logistic回归多因素分析。
结果 42例肝移植病人移植术后PGD的发生率为52.4%。PGD组和非PGD组受者术后1、6、12个月的累积生存率分别为95.45%、86.36%、86.36%和95.00%、94.44%、94.44%,组间比较差异无统计学意义(P>0.05)。供体ICU住院时间≥72 h(OR=4.612,95%CI=1.283~16.579,P<0.05)和CIT≥8 h(OR=6.097,95%CI=1.030~36.070,P<0.05)是PGD发生的独立危险因素。
结论 供体ICU住院时间≥72 h和CIT≥8 h是DCD供肝移植病人术后PGD发生的独立危险因素。缩短供体的CIT和ICU住院时间可能有助于降低肝移植术后PGD的发生率。
Abstract:
Objective  To investigate the incidence of primary graft dysfunction (PGD) after liver transplantation from donation after cardiac death (DCD) and the risk factors for PGD.
Methods  A retrospective study was performed for the clinical data of 42 donors and recipients who underwent liver transplantation in Center of Organ Transplantation in our hospital from July 2014 to March 2016. The donor data included sex, age, blood type, cause of death, length of intensive care unit (ICU) stay, degree of steatosis, cold ischemia time (CIT), warm ischemia time (WIT), and preoperative serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TB), and the recipient data included sex, age, blood type, primary disease, preoperative Model for End-Stage Liver Disease (MELD) score, intraoperative blood loss, blood transfusion volume, duration of anhepatic phase, time of operation, and length of postoperative ICU stay. A univariate analysis was performed for these factors, and then a logistic regression analysis was performed for the factors with significant difference.
Results  The incidence rate of PGD after liver transplantation was 52.4%. The 1-, 6-, and 12-month cumulative survival rates were 95.45%, 86.36%, and 86.36% in the PGD group and 95.00%, 94.44%, and 94.44% in the non-PGD group, and there were no significant differences between the two groups (P>0.05). Length of ICU stay ≥72 h (OR=4.612, 95%CI=1.283-16.579,P<0.05) and CIT ≥8 h (OR=6.097,95%CI=1.030-36.070,P<0.05) in donors were independent risk factors for PGD.
Conclusion Length of ICU stay ≥72 h and CIT ≥8 h in donors are independent risk factors for PGD. Therefore, shortening donor’s CIT and length of ICU stay may help to reduce the incidence rate of PGD after liver transplantation.
更新日期/Last Update: 2017-08-13