Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Transplantation. 2012 Dec 15;94(11):1154-9. doi: 10.1097/TP.0b013e31826ec713.
This study aims to evaluate perioperative mortality and morbidity after total hip replacement in liver transplant recipients and suggesting safety guidelines.
Hip replacement surgery is one of the most common elective surgeries even for organ transplant recipients. However, there is a paucity of literature addressing the morbidity and complications of hip replacement surgery for liver transplant recipients.
We analyzed retrospectively 33 arthroplasty cases in 20 liver transplant recipients carried out in a single center from 2005 to 2011. All perioperative clinical and laboratory data were evaluated together with early and late morbidity and mortality.
Of 2253 liver transplant recipients, 20 (0.9%) patients underwent 33 total hip arthroplasties. Thirty-two arthroplasties were performed for avascular necrosis of the femoral head, whereas only one was performed for osteoarthritis. There was no death, liver failure, or infection within 30 days after surgery. Three patients showed elevated liver enzyme more than 5 times the normal value, but it eventually decreased to normal within 1 week. Of 33 cases of arthroplasty, postoperative blood transfusion was needed in 14 cases with 1 case receiving more than 4 U. On long-term follow-up, no patients have developed periprosthetic fracture, implant loosening, or liver failure. All patients showed good to excellent postoperative Harris hip score.
In this series, we can infer that hip replacement surgery in liver transplantation patients is safe and gives a reliably good result. Some preoperative conditions should be obtained to reduce postoperative morbidity.
本研究旨在评估肝移植受者全髋关节置换术后的围手术期死亡率和发病率，并提出安全指南。
髋关节置换术是最常见的择期手术之一，即使对于器官移植受者也是如此。然而，关于肝移植受者髋关节置换术的发病率和并发症的文献很少。
我们回顾性分析了 2005 年至 2011 年期间在一家中心进行的 20 例肝移植受者的 33 例关节置换病例。评估了所有围手术期的临床和实验室数据，以及早期和晚期的发病率和死亡率。
在 2253 例肝移植受者中，有 20 例（0.9%）患者接受了 33 例全髋关节置换术。32 例关节置换术用于治疗股骨头缺血性坏死，而仅有 1 例用于治疗骨关节炎。术后 30 天内无死亡、肝功能衰竭或感染。3 例患者的肝酶升高超过正常值的 5 倍，但最终在 1 周内降至正常。33 例关节置换术中，14 例需要术后输血，其中 1 例需要输血超过 4 单位。长期随访中，无患者发生假体周围骨折、假体松动或肝功能衰竭。所有患者术后髋关节 Harris 评分均为良好至优秀。
在本系列中，我们可以推断肝移植受者髋关节置换术是安全的，并且结果可靠良好。应获得一些术前条件以降低术后发病率。
