Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Kyoto University, Japan.
Hepatobiliary Pancreat Dis Int. 2009 Aug;8(4):358-62.
Liver transplantation currently represents the ultimate therapy for bleeding esophageal varices in patients with liver cirrhosis. It is the only therapy that cures both portal hypertension and the underlying liver disease. The outcome of liver transplantation is thought to be correlated with several factors. In this study, the clinical outcome of living-related liver transplantation (LRLT) was evaluated in patients with variceal bleeding, and the prognostic indicators of short-term survival in these patients were identified.
We reviewed retrospectively 121 patients with a history of variceal bleeding who had received LRLT from 1998 to 2006. The clinical outcomes were analyzed, and the risk factors for short-term survival were defined.
The 3-month survival rate of patients with variceal bleeding was 83.4%, while that of non-bleeders was 87%. Sepsis was the commonest cause of death in both groups. Portal vein diameter and blood transfusion were the only independent prognostic factors for short-term survival among variceal bleeders.
The outcome of LRLT in recipients with variceal bleeding is based on the improvement of portal hemodynamics, by minimizing intraoperative blood loss and subsequent blood transfusion.
肝移植目前是肝硬化患者食管静脉曲张出血的终极治疗方法。它是唯一能同时治疗门脉高压和潜在肝脏疾病的方法。肝移植的结果被认为与多个因素有关。在这项研究中，评估了活体肝移植（LRLT）治疗静脉曲张出血患者的临床结果，并确定了这些患者短期生存的预后指标。
我们回顾性分析了 1998 年至 2006 年间接受 LRLT 的 121 例有静脉曲张出血史的患者。分析了临床结果，并确定了短期生存的危险因素。
静脉曲张出血患者的 3 个月生存率为 83.4%，而非出血患者为 87%。两组中最常见的死亡原因是感染。门静脉直径和输血是静脉曲张出血患者短期生存的唯一独立预后因素。
LRLT 治疗静脉曲张出血患者的结果取决于通过最大限度地减少术中失血和随后的输血来改善门脉血流动力学。
