Nanashima A, Pillay P, Crawford M, Nakasuji M, Verran D J, Painter D
Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW 2050, Australia.
J Hepatobiliary Pancreat Surg. 2001;8(6):557-63. doi: 10.1007/s005340100025.
BACKGROUND/PURPOSE: We investigated the causes and examined patient outcomes following the postrevascularization syndrome (PRS) during orthotopic liver transplantation (OLTx).
PRS was defined as a fall in the mean arterial pressure at 5 min after revascularization to less than 70% of the baseline and lasting for 5 min. Data from 100 adult patients who underwent OLTx between January 1998 and September 2000 were analyzed. Analyzed data included donor and recipient demographic data, recipient operative and postoperative courses, and recipient outcome.
Twenty-nine patients (29%) exhibited PRS during OLTx (PRS group). There was a higher incidence of older donors (>50 years) in the PRS group (48% vs 23%; P < 0.05). Postrevascularization hyperkalemia and metabolic acidosis were observed in both the PRS and non-PRS groups. Transaminase and lactate levels after revascularization were significantly higher in the PRS group ( P < 0.05). Alkaline phosphatase and gamma-glutamyl transpeptidase levels on day 7 tended to be higher in the PRS group; although the difference was not significant (p > or = 0.05). Serum creatinine was significantly elevated on day 7 in the PRS group ( P < 0.01).
Our results indicate that PRS following OLTx tended to be more common in liver allografts from older donors and was associated with posttransplantation liver and renal dysfunction.
背景/目的：我们调查了原位肝移植（OLTx）期间血管再通综合征（PRS）的病因，并检查了患者的预后情况。
PRS定义为血管再通后5分钟平均动脉压降至基线的70%以下，并持续5分钟。对1998年1月至2000年9月期间接受OLTx的100例成年患者的数据进行分析。分析的数据包括供体和受体的人口统计学数据、受体的手术及术后病程以及受体的预后情况。
29例患者（29%）在OLTx期间出现PRS（PRS组）。PRS组中年龄较大的供体（>50岁）的发生率较高（48%对23%；P<0.05）。PRS组和非PRS组均观察到血管再通后高钾血症和代谢性酸中毒。PRS组血管再通后的转氨酶和乳酸水平显著更高（P<0.05）。PRS组第7天的碱性磷酸酶和γ-谷氨酰转肽酶水平有升高趋势；尽管差异不显著（P≥0.05）。PRS组第7天血清肌酐显著升高（P<0.01）。
我们的结果表明，OLTx后的PRS在来自年龄较大供体的肝移植中更常见，并与移植后肝脏和肾功能障碍相关。
