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患有门静脉血栓形成和/或曾接受过手术的受者。

The recipient with portal thrombosis and/or previous surgery.

作者信息

Arcadipane A, Nadalin S, Gruttadauria S, Panarello G, Burgio G, Vizzini G, Luca A, Gridelli B

机构信息

Department of Anesthesia and Intensive Care, ISMETT, Palermo, Italy.

出版信息

Transplant Proc. 2008 May;40(4):1183-6. doi: 10.1016/j.transproceed.2008.03.073.

Abstract

INTRODUCTION

Portal vein thrombosis (PVT) has been considered to be an absolute contraindication to liver transplantation (OLT) and previous upper abdominal surgery was considered to render it a high-risk procedure. Currently, these are only conditions considered risk factors increasing recipient morbidity and mortality. The objective of this study was to compare OLT perioperative morbidity, mortality, blood product consumption, and length of hospital stay among patients with or without PVT or with or without previous surgery.

MATERIALS AND METHODS

Among 366 OLTs performed between July 1999 and November 2007, 33 liver transplant recipients displayed previous PVT while 34 had undergone previous surgery. The two groups of marginal recipients were compared with a cohort of 33 patients without PVT or previous surgery.

RESULTS

The groups were homogeneous in terms of epidemiological variables, surgical techniques, and donor-related variables. In the PVT group, all analyzed parameters were the same as the control group; surgical time, anhepatic phase duration, early surgical complication, intensive care unit and hospital length of stay, and overall mortality. The only significant difference was the incidence of portal rethrombosis (P < .035). Among the previous surgery group, we did not observe significant differences.

CONCLUSIONS

PVT and previous surgery should no longer be considered contraindications for OLT.

摘要

引言

门静脉血栓形成(PVT)一直被视为肝移植(OLT)的绝对禁忌证,而既往上腹部手术也被认为会使其成为高风险手术。目前,这些仅被视为增加受者发病率和死亡率的危险因素。本研究的目的是比较有或无PVT以及有或无既往手术的患者在OLT围手术期的发病率、死亡率、血液制品消耗量和住院时间。

材料与方法

在1999年7月至2007年11月期间进行的366例OLT中,33例肝移植受者有既往PVT,34例有既往手术史。将这两组边缘受者与33例无PVT或既往手术史的患者队列进行比较。

结果

在流行病学变量、手术技术和供体相关变量方面,各组具有同质性。在PVT组中,所有分析参数与对照组相同;手术时间、无肝期持续时间、早期手术并发症、重症监护病房和住院时间以及总死亡率。唯一显著差异是门静脉再血栓形成的发生率(P <.035)。在既往手术组中,我们未观察到显著差异。

结论

PVT和既往手术不应再被视为OLT的禁忌证。

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