Al-Sebayel Mohammed, Khalaf Hatem, Al-Sofayan Mohammed, Al-Saghier Mohammed, Abdo Ayman, Al-Bahili Hamad, El-Sheikh Yasser, Helmy Ahmed, Medhat Yasser
Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Ann Saudi Med. 2007 Sep-Oct;27(5):333-8. doi: 10.5144/0256-4947.2007.333.
Saudi Arabia is a leading country in the Middle East in the field of deceased-donor liver transplantation (DDLT) and living-donor liver transplantation (LDLT). We present out experience with DDLT and LDLT at King Faisal Specialist Hospital and Research Center (KFSHRC) for the period from April 2001 to January 2007.
We performed 122 LT procedures (77 DDLTs and 45 LDLTs) in 118 patients (4 re-transplants) during this period of time.
The number of adult and pediatric procedures was 107 and 11, respectively. The overall male/female ratio was 66/52 and the median age of patients was 43 years (range, 2-63 years). In the DDLT group, the median operating time was 8 hours (range, 4-19), the median blood transfusion was 6 units (range, 0-40), and the median hospital stay was 13 days (range, 6-183). In the DDLT group, after a mean follow-up period of 760 days (range, 2-2085), the overall patient and graft survival rate was 86%. In the LDLT group, the median operating time was 11 hours (range, 7-17), the median blood transfusion was 4 units (range, 0-65), and the median hospital stay was 15 days (range, 7-127). In the LDLT group, and after a mean follow-up period of 685 days (range, 26- 1540), the overall patient and graft survival rates were 90% and 80%, respectively with no significant difference in patient and graft survivals between groups. Biliary complications were significantly higher in LDLT compared to DDLT (P<0.05). Vascular complications were also significantly higher in LDLT compared DDLT (P<0.05).
Both DDLT and LDLT are being successfully performed at KFSHRC with early experience indicating a higher rate of biliary and vascular complications in the LDLT group.
沙特阿拉伯在尸体供肝肝移植(DDLT)和活体供肝肝移植(LDLT)领域是中东地区的领先国家。我们介绍了2001年4月至2007年1月期间在法赫德国王专科医院及研究中心(KFSHRC)开展DDLT和LDLT的经验。
在此期间,我们为118例患者(4例再次移植)实施了122例肝移植手术(77例DDLT和45例LDLT)。
成人和儿童手术例数分别为107例和11例。总体男女比例为66/52,患者中位年龄为43岁(范围2 - 63岁)。在DDLT组,中位手术时间为8小时(范围4 - 19小时),中位输血量为6单位(范围0 - 40单位),中位住院时间为13天(范围6 - 183天)。在DDLT组,平均随访760天(范围2 - 2085天)后,总体患者和移植物存活率为86%。在LDLT组,中位手术时间为11小时(范围7 - 17小时),中位输血量为4单位(范围0 - 65单位),中位住院时间为15天(范围7 - 127天)。在LDLT组,平均随访685天(范围26 - 1540天)后,总体患者和移植物存活率分别为90%和80%,两组间患者和移植物存活率无显著差异。LDLT组的胆道并发症明显高于DDLT组(P<0.05)。LDLT组的血管并发症也明显高于DDLT组(P<0.05)。
KFSHRC成功开展了DDLT和LDLT,早期经验表明LDLT组的胆道和血管并发症发生率较高。