Li Chuan, Wen Tian-Fu, Yan Lu-Nan, Li Bo
From the Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, China.
Exp Clin Transplant. 2014 Oct;12(5):424-8. doi: 10.6002/ect.2013.0223. Epub 2014 Feb 25.
The purpose of this study was to identify the incidence, outcomes, and risk factors of postoperative abdominal bleeding after living-donor liver transplant.
Adult patients who had living-donor liver transplant between 2001 and 2013 were evaluated. Preoperative and intraoperative variables of transplant recipients were analyzed retrospectively with univariate analysis. Cox proportional hazards regression model was used to identify independent factors for postoperative bleeding.
There were 241 living-donor liver transplant recipients included in the study. Postoperative abdominal bleeding was observed in 12 recipients (5%). The 3-month cumulative survival was significantly lower in recipients who had postoperative bleeding (survival, 8 patients [67%]) than recipients who did not have postoperative bleeding (survival, 204 patients [89%]; P = .009). Univariate analysis showed that preoperative albumin level, Child-Pugh class, and intraoperative blood loss were risk factors for postoperative bleeding. In multivariate analysis, intraoperative blood loss and Child-Pugh status were significant risk factors for postoperative bleeding.
Living-donor liver transplant recipients who had postoperative bleeding had a poor outcome. Postoperative bleeding was associated with higher intraoperative blood loss and Child-Pugh class.
本研究旨在确定活体肝移植术后腹腔出血的发生率、结局及危险因素。
对2001年至2013年间接受活体肝移植的成年患者进行评估。对移植受者的术前和术中变量进行回顾性单因素分析。采用Cox比例风险回归模型确定术后出血的独立因素。
本研究共纳入241例活体肝移植受者。12例受者（5%）出现术后腹腔出血。术后出血的受者3个月累积生存率（存活8例[67%]）显著低于未发生术后出血的受者（存活204例[89%]；P = 0.009）。单因素分析显示，术前白蛋白水平、Child-Pugh分级和术中失血量是术后出血的危险因素。多因素分析中，术中失血量和Child-Pugh分级是术后出血的显著危险因素。
发生术后出血的活体肝移植受者结局较差。术后出血与术中失血量增加和Child-Pugh分级相关。
