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活体右半肝供体术后高胆红素血症的预测因素:210例单中心分析

Prediction factors of postoperative hyperbilirubinemia in living right lobe donor: a single-center analysis of 210 cases.

作者信息

Lei J Y, Yan L N, Wang W T

机构信息

Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China.

出版信息

Transplant Proc. 2013 Jan-Feb;45(1):205-11. doi: 10.1016/j.transproceed.2012.03.063.

Abstract

BACKGROUND

Hyperbilirubinemia in living liver donor is very common, but the causes are still unclear.

AIMS

We sought to clarify the risk factors and predictors of nonobstructive hyperbilirubinemia among living donors.

METHODS

We divided 210 consecutive right liver lobe donors into two groups according to the peak total bilirubin postoperatively. We collected data on preoperative, intraoperative, and postoperative biochemical measurements retrospectively, performing multivariate logistic regression analysis adjusting for potential confounders of the risk of hyperbilirubinemia.

RESULTS

There were significant differences between the two groups in donor age, body mass index, operative time, blood loss, macrovescicular steatosis, allogeneic blood transfusion rate, intensive care unit stay, hospital stay and Clavien score after donation (P < .05). Age, graft/donor weight, operative time, and blood loss were significantly associated with the risk of hyperbilirubinemia upon logistic regression analysis.

CONCLUSION

Hyperbilirubinemia, one type of hepatic dysfunction after a living donor procedure, was associated with multiple independent risk factors.

摘要

背景

活体肝供者高胆红素血症非常常见,但病因仍不清楚。

目的

我们试图阐明活体供者中非梗阻性高胆红素血症的危险因素和预测因素。

方法

我们根据术后总胆红素峰值将210例连续的右肝叶供者分为两组。我们回顾性收集术前、术中和术后生化检测数据,进行多因素逻辑回归分析,对高胆红素血症风险的潜在混杂因素进行校正。

结果

两组在供者年龄、体重指数、手术时间、失血量、大泡性脂肪变性、异体输血率、重症监护病房停留时间、住院时间和捐献后Clavien评分方面存在显著差异(P <.05)。经逻辑回归分析,年龄、移植物/供者体重、手术时间和失血量与高胆红素血症风险显著相关。

结论

高胆红素血症是活体供者手术后肝功能障碍的一种类型,与多种独立危险因素相关。

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