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右叶成人活体供者的并发症:中国单中心经验

Complications in the right lobe adult living donor: single-center experience in China.

作者信息

Li F, Yan L, Li B, Zeng Y, Wen T, Xu M, Wang W, Chen Z, Yang J, Liu B, Jiang X

机构信息

Center of Liver Transplantation, West China Hospital, Sichuan University, Sichuan, Province, People's Republic of China.

出版信息

Transplant Proc. 2007 Dec;39(10):2977-80. doi: 10.1016/j.transproceed.2007.09.034.

Abstract

INTRODUCTION AND OBJECTIVE

Living donor liver transplantation (LDLT) has been accepted as an established treatment modality for end-stage liver diseases to alleviate the shortage of cadaveric organs. Reported complication rates for right lobe adult living donors vary, but are estimated to be approximately 35% with a surgical mortality rate of approximately 0.3%. Our objective was to evaluate the complications in right lobe adult living donors in a single center.

MATERIALS AND METHODS

This retrospective review includes 62 adult living donors who underwent right hemi-hepatectomy between January 2002 and December 2006. Eighteen donors were men and 44 were women (range, 18-65 years; median age, 36 years). The mean follow-up time for the donors was 16 months (range, 3 months-4 years).

RESULTS

All donors were alive and well at the end of the study period. Complications included pleural effusion (n=6; 9.68%), bile leaks (n=3; 4.84%), wound infection (n=2; 3.23%), pneumonia (n=2; 3.23%), chyle leak (n=1; 1.61%), intra-abdominal bleeding (n=1; 1.61%), subphrenic effusion (n=1; 1.61%), portal vein thrombosis (n=1; 1.61%), and chylothorax (n=1; 1.61%). There was no donor mortality, and the overall complication rate was 29%.

CONCLUSIONS

The overall complication rate in the right lobe adult living donor was 29% in our center; there was no donor mortality. These complications could be avoided or overcome through intensive postoperative surveillance.

摘要

引言与目的

活体肝移植(LDLT)已被公认为是治疗终末期肝病的一种成熟治疗方式,以缓解尸体器官短缺的问题。报道的右半肝成人活体供体的并发症发生率各不相同,但估计约为35%,手术死亡率约为0.3%。我们的目的是评估单中心右半肝成人活体供体的并发症情况。

材料与方法

这项回顾性研究纳入了2002年1月至2006年12月期间接受右半肝切除术的62例成人活体供体。18例为男性,44例为女性(年龄范围18 - 65岁;中位年龄36岁)。供体的平均随访时间为16个月(范围3个月 - 4年)。

结果

在研究期末,所有供体均存活且状况良好。并发症包括胸腔积液(n = 6;9.68%)、胆漏(n = 3;4.84%)、伤口感染(n = 2;3.23%)、肺炎(n = 2;3.23%)、乳糜漏(n = 1;1.61%)、腹腔内出血(n = 1;1.61%)、膈下积液(n = 1;1.61%)、门静脉血栓形成(n = 1;1.61%)和乳糜胸(n = 1;1.61%)。无供体死亡,总体并发症发生率为29%。

结论

在我们中心,右半肝成人活体供体的总体并发症发生率为29%;无供体死亡。通过术后密切监测,这些并发症可以避免或得到控制。

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