Ikegami T, Nishizaki T, Yanaga K, Shimada M, Kishikawa K, Nomoto K, Uchiyama H, Sugimachi K
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Transplantation. 2000 Dec 27;70(12):1703-7. doi: 10.1097/00007890-200012270-00007.
The impact of the age of the donor on the outcome of living related liver transplantation is yet to be clarified.
During October 14, 1996 and December 20, 1999, 34 living related liver transplantations were performed. Of these, 26 cases were performed using the extended left lobe graft, which were classified into three groups; younger donor group (group Y, donor age < 30, n = 7), middle-aged donor group (group M, 30 < or = donor age <50, n=13), and older donor group (group O, donor age < 50, n = 6). Early allograft function and regeneration were compared between these groups.
There was no difference in standard liver volume, and predicted or harvested graft size between the three groups. Although serum transaminase and total bilirubin levels within postoperative day 7 were not different between the groups, the prothrombin time on postoperative day 3 was significantly longer in group O than in group Y. One week after transplantation, group Y had significantly greater graft/standard liver volume ratio than group O, and greater graft volume than group M and O. One month after transplantation, however, there was no significant difference in such graft size parameters between the groups. Graft and patient survival were comparable between the three groups.
Although function and regeneration of the allografts from older donors in living donor liver transplantation is worse than those of their younger counterparts, the outcome is not affected by the age of the liver.
供体年龄对亲属活体肝移植结果的影响尚待阐明。
在1996年10月14日至1999年12月20日期间,进行了34例亲属活体肝移植。其中,26例采用扩大左叶移植物,分为三组;年轻供体组(Y组,供体年龄<30岁,n = 7)、中年供体组(M组,30≤供体年龄<50岁,n = 13)和老年供体组(O组,供体年龄≥50岁,n = 6)。比较这些组之间的早期移植物功能和再生情况。
三组之间的标准肝体积、预测或获取的移植物大小没有差异。虽然术后第7天内的血清转氨酶和总胆红素水平在组间没有差异,但术后第3天O组的凝血酶原时间明显长于Y组。移植后一周,Y组的移植物/标准肝体积比明显大于O组,移植物体积大于M组和O组。然而,移植后一个月,这些移植物大小参数在组间没有显著差异。三组之间的移植物和患者生存率相当。
虽然活体肝移植中老年供体的移植物功能和再生比年轻供体的移植物差,但结果不受肝脏年龄的影响。