Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Dig Liver Dis. 2012 Jul;44(7):597-602. doi: 10.1016/j.dld.2012.01.016. Epub 2012 Mar 3.
The number of living donor liver transplantations performed has increased rapidly in many Eastern transplant centres. However, the impact of the transplant centres' experience and learning on the transplant outcomes are not well established. Aim of the study was to evaluate the learning curve for living donor liver transplantation in our centre.
Data from 156 recipients and 156 donors who underwent surgery were reviewed. Intraoperative data and postoperative outcomes of both donors and recipients were retrospectively analysed. Recipients and donors were divided into three groups that consisted of 52 consecutive cases each.
Surgical duration and intraoperative blood loss during donor surgery were decreased significantly between the earlier and the more recent cases (423±39 vs. 400±44 min and 959±523 vs. 731±278 mL, respectively; P<0.01). Rates of postoperative complications and functional changes were not statistically different amongst the three donor groups. Immediate complication rate of the first 52 recipients was higher than those of the second and third cohorts. Long-term survival rates of the three recipient groups were similar.
The learning curve greatly influenced immediate outcomes of recipients during the early transplant period. However, it had little influence on donor outcome; long-term outcome improvement of recipients did not depend on the accumulation of experience alone.
在许多东方移植中心，活体供肝移植的数量迅速增加。然而，移植中心的经验和学习对移植结果的影响尚未得到很好的证实。本研究旨在评估我们中心活体供肝移植的学习曲线。
回顾了 156 名受者和 156 名供者接受手术的数据。回顾性分析了供者和受者的术中数据和术后结果。受者和供者被分为三组，每组 52 例连续病例。
供体手术中的手术时间和术中出血量在早期和近期病例之间显著减少（423±39 对 400±44 分钟和 959±523 对 731±278 毫升；P<0.01）。三组供体术后并发症和功能变化发生率无统计学差异。前 52 名受者的即刻并发症发生率高于第二和第三队列。三组受者的长期生存率相似。
学习曲线在早期移植期间极大地影响了受者的即时结果。然而，它对供体结果的影响很小；受者的长期预后改善并不取决于经验的积累。
