供体安全与活体肝移植中的残肝体积。

Donor safety and remnant liver volume in living donor liver transplantation.

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.

出版信息

World J Gastroenterol. 2012 Dec 28;18(48):7327-32. doi: 10.3748/wjg.v18.i48.7327.

DOI:10.3748/wjg.v18.i48.7327

PMID:23326141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3544038/

Abstract

AIM

To evaluate the relationship between donor safety and remnant liver volume in right lobe living donor liver transplantation (LDLT).

METHODS

From July 2001 to January 2009, our liver transplant centers carried out 197 LDLTs. The clinical data from 151 cases of adult right lobe living donors (not including the middle hepatic vein) were analyzed. The conditions of the three groups of donors were well matched in terms of the studied parameters. The donors' preoperative data, intraoperative and postoperative data were calculated for the three groups: Group 1 remnant liver volume (RLV) < 35%, group 2 RLV 36%-40%, and group 3 RLV > 40%. Comparisons included the different remnant liver volumes on postoperative liver function recovery and the impact of systemic conditions. Correlations between remnant liver volume and post-operative complications were also analyzed.

RESULTS

The donors' anthroposomatology data, operation time, and preoperative donor blood test indicators were calculated for the three groups. No significant differences were observed between the donors' gender, age, height, weight, and operation time. According to the Chengdu standard liver volume formula, the total liver volume of group 1 was 1072.88 ± 131.06 mL, group 2 was 1043.84 ± 97.11 mL, and group 3 was 1065.33 ± 136.02 mL. The three groups showed no statistically significant differences. When the volume of the remnant liver was less than 35% of the total liver volume, the volume of the remnant had a significant effect on the recovery of liver function and intensive care unit time. In addition, the occurrence of complications was closely related to the remnant liver volume. When the volume of the remnant liver was more than 35% of the total liver volume, the remnant volume change had no significant effect on donor recovery.

CONCLUSION

To ensure donor safety, the remnant liver volume should be greater than the standard liver volume (35%) in right lobe living donor liver transplantation.

摘要

目的

评估右叶活体肝移植（LDLT）中供体安全性与剩余肝体积之间的关系。

方法

自 2001 年 7 月至 2009 年 1 月，我院肝脏移植中心共进行了 197 例 LDLT。分析了 151 例成人右叶活体供者（不包括中肝静脉）的临床资料。供者术前、术中、术后资料计算三组：组 1 残肝体积（RLV）＜35%，组 2 RLV 36%-40%，组 3 RLV＞40%。比较三组术后肝功能恢复不同残肝量和全身状况的影响。分析残肝量与术后并发症的关系。

结果

三组供者人体测量学数据、手术时间及术前供者血液检查指标。供者性别、年龄、身高、体重、手术时间无显著性差异。根据成都标准肝体积公式，组 1 总肝体积为 1072.88±131.06ml，组 2 为 1043.84±97.11ml，组 3 为 1065.33±136.02ml。三组无统计学差异。当剩余肝体积小于总肝体积的 35%时，剩余肝体积对肝功能恢复和重症监护室时间有显著影响。此外，并发症的发生与剩余肝体积密切相关。当剩余肝体积大于总肝体积的 35%时，剩余肝体积的变化对供者恢复无显著影响。