Yoo T, Kim S H, Kim Y-K, Cho S Y, Park S-J
Center for Liver Cancer, National Cancer Center, Goyang-Si, Gyeonggi-Do, Republic of Korea.
Transplant Proc. 2013 Jan-Feb;45(1):222-4. doi: 10.1016/j.transproceed.2012.02.043.
At many centers, various heparin doses have been administrated systemically during living donor partial hepatectomy in an effort to minimize the potential for graft vascular thrombosis, which could lead to delayed graft function. However, there is no consensus regarding the advisability of heparin administration during living donor hepatectomy for liver transplantation.
We prospectively enrolled 270 donors between 2005 and 2011 to investigate donor and recipient outcomes between a low dose (25 IU/kg) and a conventional dose of heparin (50 IU/kg).
The low-dose heparin group did not show an increased incidence of vascular thrombosis: the rates of hepatic artery and portal vein thromboses were not significantly different between the two groups (P = .935 and P = .158, respectively). In addition, injection of low-dose heparin reduced donor complications with significant differences in postoperative hospital stay (P < .001), donor operative time (P < .001), hemoglobin/hematocrit decrease (P = .05/P = .02) and hemorrhagic complications (P = .004).
Administration of low-dose heparin during living donor hepatectomy can be used without worsening vascular thrombosis or donor complications.
在许多中心，活体供肝部分肝切除术期间已全身给予各种肝素剂量，以尽量减少移植物血管血栓形成的可能性，而这可能导致移植物功能延迟。然而，对于肝移植活体供肝肝切除术中使用肝素的 advisability 尚无共识。
我们在2005年至2011年间前瞻性纳入了270名供体，以研究低剂量（25 IU/kg）和常规剂量肝素（50 IU/kg）之间的供体和受体结局。
低剂量肝素组未显示血管血栓形成发生率增加：两组肝动脉和门静脉血栓形成率无显著差异（分别为P = 0.935和P = 0.158）。此外，低剂量肝素注射减少了供体并发症，在术后住院时间（P < 0.001）、供体手术时间（P < 0.001）、血红蛋白/血细胞比容降低（P = 0.05/P = 0.02）和出血并发症（P = 0.004）方面存在显著差异。
活体供肝肝切除术期间给予低剂量肝素可在不加重血管血栓形成或供体并发症的情况下使用。
