使用活体供体右肝移植物进行再次移植。

Retransplantation using living-donor right-liver grafts.

作者信息

Dai Wing Chiu, Chan See Ching, Chok Kenneth S H, Cheung Tan To, Sharr William W, Chan Albert C Y, Fung James Y Y, Wong Tiffany C L, Lo Chung Mau

机构信息

Department of Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.

出版信息

J Hepatobiliary Pancreat Sci. 2014 Aug;21(8):579-84. doi: 10.1002/jhbp.100. Epub 2014 Feb 18.

DOI:10.1002/jhbp.100

PMID:24550160

Abstract

BACKGROUND

This study reviews the outcomes of retransplantation using living-donor right-liver grafts.

METHODS

A retrospective study of liver retransplants performed between 1996 and 2013 was conducted. The retransplants were divided into the DD group (with deceased donors) and the LD group (with living donors). Survival outcomes were analyzed.

RESULTS

The DD group contained 23 patients and 27 retransplants using whole-liver grafts and the LD group contained 11 patients and 11 retransplants using right-liver grafts. Vascular and biliary complications were the main indications for retransplantation in both groups. The LD group had significantly younger donors, lighter grafts, shorter cold ischemia and longer operations. The two groups were comparable in age, preoperative liver function, warm ischemia, blood loss, transfusion, intensive care unit stay, hospital stay, hospital mortality, complication and graft loss. The 1-year, 3-year and 5-year patient survival rates were 78.3%, 73.7% and 63.8%, respectively, in the DD group. The LD group had the corresponding rates all at 90.9% (P = 0.246). The 1-year, 3-year and 5-year graft survival rates were 74.1%, 65.8% and 61.5%, respectively, in the DD group. The LD group had the corresponding rates all at 90.9% (P = 0.132).

CONCLUSION

Excellent long-term survival after retransplantation using living-donor right-liver grafts can be achieved.

摘要

背景

本研究回顾了使用活体供体右肝移植物进行再次移植的结果。

方法

对1996年至2013年间进行的肝再次移植进行回顾性研究。将再次移植分为DD组（尸体供体）和LD组（活体供体）。分析生存结果。

结果

DD组有23例患者和27次使用全肝移植物的再次移植，LD组有11例患者和11次使用右肝移植物的再次移植。血管和胆道并发症是两组再次移植的主要指征。LD组的供体明显更年轻，移植物更轻，冷缺血时间更短，手术时间更长。两组在年龄、术前肝功能、热缺血、失血量、输血、重症监护病房停留时间、住院时间、医院死亡率、并发症和移植物丢失方面具有可比性。DD组的1年、3年和5年患者生存率分别为78.3%、73.7%和63.8%。LD组的相应生存率均为90.9%（P = 0.246）。DD组的1年、3年和5年移植物生存率分别为74.1%、65.8%和61.5%。LD组的相应生存率均为90.9%（P = 0.132）。