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高压氧治疗对成人活体肝移植左叶供体术后发病率的影响。

The effect of hyperbaric oxygen treatment on postoperative morbidity of left lobe donor in living donor adult liver transplantation.

作者信息

Suehiro Taketoshi, Shimura Tatsuo, Okamura Kaori, Okada Toshiyuki, Okada Koji, Hashimoto Shinji, Mochida Yasushi, Kuwano Hiroyuki, Saitoh Shigeru, Gotoh Fumio

机构信息

Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi 371-8511, Japan.

出版信息

Hepatogastroenterology. 2008 May-Jun;55(84):1014-9.

Abstract

BACKGROUND/AIMS: In living donor liver transplantation (LDLT), donor safety has top priority, and donor morbidity should be minimized to zero. However, several corporal problems still remain. The effect of hyperbaric oxygenation treatment (HBO) was evaluated for donor morbidity in LDLT.

METHODOLOGY

A total of 14 consecutive donors were studied. The donors into were divided into 2 groups as follows: HBO group (n=7), which started HBO 3 days after operation, and a control group (n=7). Patient's factors, graft volume, liver regeneration rate, liver function tests and postoperative complications ware compared between the 2 groups.

RESULTS

There was no significant difference between the groups in whole liver, graft and remnant liver volume. The incidence of wound numbness on POD 28 was 86% (6/7) in the control group and 29% (2/7) in the HBO group (p<0.05). Postoperative hospital stay was 14.4 and 14.6 days in the control and HBO group, respectively (p=NS). On POD 14, AST value in the HBO group was significantly lower than in the control group (p<0.05). PT% value in the HBO group was significantly higher than in the control group on POD 14 (p<0.05). Total bilirubin level in the HBO group was significantly lower than in the control group on POD 14 and 28 (p<0.05), and total bile acid value in the HBO group was significantly lower than the control group (p<0.05) on POD 14. Albumin level in the HBO group was significantly higher than the control group on POD 7, 10 and 28 (p<0.05). Four weeks after the operation, the regeneration rate was significantly higher in the HBO group than in the control group (p<0.05).

CONCLUSIONS

Liver regeneration was promoted by HBO preserving a function in LDLT using left lobe graft. Hyperbaric oxygen therapy seems to be very useful to LDLT.

摘要

背景/目的:在活体肝移植(LDLT)中,供体安全是首要任务,供体并发症应降至零。然而,仍存在一些身体问题。评估了高压氧治疗(HBO)对LDLT供体并发症的影响。

方法

共研究了14例连续的供体。将供体分为以下2组:HBO组(n = 7),术后3天开始HBO治疗;对照组(n = 7)。比较两组患者的因素、移植肝体积、肝再生率、肝功能检查及术后并发症。

结果

两组在全肝、移植肝和残余肝体积方面无显著差异。术后第28天伤口麻木的发生率在对照组为86%(6/7),在HBO组为29%(2/7)(p<0.05)。对照组和HBO组的术后住院时间分别为14.4天和14.6天(p = 无显著性差异)。术后第14天,HBO组的AST值显著低于对照组(p<0.05)。术后第14天,HBO组的PT%值显著高于对照组(p<0.05)。术后第14天和第28天,HBO组的总胆红素水平显著低于对照组(p<0.05),术后第14天,HBO组的总胆汁酸值显著低于对照组(p<0.05)。术后第7天、第10天和第28天,HBO组的白蛋白水平显著高于对照组(p<0.05)。术后四周,HBO组的再生率显著高于对照组(p<0.05)。

结论

在使用左叶移植的LDLT中,HBO促进了肝再生并保留了肝功能。高压氧治疗似乎对LDLT非常有用。

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