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移植中中度脂肪变性供肝的疗效与安全性

Efficacy and safety of moderately steatotic donor liver in transplantation.

作者信息

Gao Feng, Xu Xiao, Ling Qi, Wu Jian, Zhou Lin, Xie Hai-Yang, Wang Hui-Ping, Zheng Shu-Sen

机构信息

Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2009 Feb;8(1):29-33.

Abstract

BACKGROUND

The discrepancy between available livers and requests for transplantation has forced many centers to use marginal donors in order to expand the donor pool. Many previous studies have demonstrated controversial results of the application of steatotic liver grafts. The aim of the present study was to summarize our experience and evaluate the value of steatotic liver grafts.

METHODS

The clinical and follow-up data of 24 adult patients receiving moderately steatotic liver grafts (30%-60%) from May 2003 to June 2005 (group 1) were analyzed. After matching for age, gender, model for end-stage liver diseases score and cold ischemia time, another 24 patients receiving liver grafts with steatosis less than 30% were chosen as the control group (group 2). The patient and graft outcomes were compared between the two groups.

RESULTS

No difference of liver and kidney functions in the first post-transplant week was found between the two groups (P>0.05). Neither the incidence of early allograft dysfunction and acute kidney injury nor the patient survival rates (3 months, 6 months and 1 year) showed differences between groups 1 and 2 (P>0.05).

CONCLUSION

Moderately steatotic liver grafts provide adequate function in the first phase after transplantation and can be used for transplantation.

摘要

背景

可用肝脏数量与移植需求之间的差距迫使许多中心使用边缘供体以扩大供体库。此前许多研究已证明应用脂肪变性肝移植物的结果存在争议。本研究的目的是总结我们的经验并评估脂肪变性肝移植物的价值。

方法

分析了2003年5月至2005年6月期间24例接受中度脂肪变性肝移植物(30%-60%)的成年患者的临床及随访数据(第1组)。在匹配年龄、性别、终末期肝病模型评分和冷缺血时间后,另外24例接受脂肪变性程度小于30%肝移植物的患者被选为对照组(第2组)。比较两组患者及移植物的结局。

结果

两组术后第1周的肝肾功能无差异(P>0.05)。第1组和第2组之间早期移植物功能障碍和急性肾损伤的发生率以及患者生存率(3个月、6个月和1年)均无差异(P>0.05)。

结论

中度脂肪变性肝移植物在移植后的第一阶段能提供足够的功能,可用于移植。

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