Feng Xi, Wei Yong-gang, Li Fu-qiang, Yuan Ding, Jiang Hua, Du Zheng-gui, Yin Jie, Li Bo
Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2008 Sep;39(5):801-4.
To investigate the relationship between the pretransplant condition of recipient, graft size and the outcomes of recipient after adult-to-adult living donor liver transplantation.
From January 2002 to January 2007, 70 patients underwent adult-to-adult living donor liver transplantation (ALDLT) in West China Hospital. There were 67 patients received right lobe graft without middle hepatic vein (MHV) and 3 patients received dual grafts. The patients were followed up until January 2008. The recipients were stratified according to pretransplant MELD-AS score and graft size. The outcomes of these patients were analyzed retrospectively.
Recipient 1-year survival rate and complication rate were 87.1% and 34.3%, respectively. For the patients with MELD-AS score from 1 to 13, the survival rates of large graft and small graft were 100.0% and 83.3%, the complication rates were 14.3% and 16.7%; for those MELD-AS score between 14-24, the survival rates of large graft and small graft were 94.4% and 75.0%, the complication rates were 38.9% and 50.0%; for those MELD-AS scores were 25 or higher, the survival rates of large graft and small graft were 77.8% and 25.0%, the complication rates were 52.9% and 50.0%. Statistical significant difference of survival between large graft group and small graft group was found among the recipients with MELD-AS score > or =25.
The recipient survival is influenced simutanously by pretransplant MELD-AS score of recipient and graft size influence. Further more, large graft improve the survival in recipients whose MELD-AS score were 25 or higher.
探讨成人活体肝移植受体移植前状况、移植肝大小与受体预后的关系。
2002年1月至2007年1月，70例患者在华西医院接受成人活体肝移植（ALDLT）。其中67例接受无肝中静脉（MHV）的右叶移植肝，3例接受双叶移植肝。对患者随访至2008年1月。根据移植前MELD-AS评分和移植肝大小对受体进行分层。对这些患者的预后进行回顾性分析。
受体1年生存率和并发症发生率分别为87.1%和34.3%。MELD-AS评分为1至13分的患者，大体积移植肝和小体积移植肝的生存率分别为100.0%和83.3%，并发症发生率分别为14.3%和16.7%；MELD-AS评分为14至24分的患者，大体积移植肝和小体积移植肝的生存率分别为94.4%和75.0%，并发症发生率分别为38.9%和50.0%；MELD-AS评分25分及以上的患者，大体积移植肝和小体积移植肝的生存率分别为77.8%和25.0%，并发症发生率分别为52.9%和50.0%。在MELD-AS评分≥25分的受体中，大体积移植肝组和小体积移植肝组的生存率差异有统计学意义。
受体的生存同时受到移植前MELD-AS评分和移植肝大小的影响。此外，大体积移植肝可提高MELD-AS评分25分及以上受体的生存率。
