移植肝脂肪变性作为肝移植中缺血型胆管病变的危险因素。

Graft steatosis as a risk factor of ischemic-type biliary lesions in liver transplantation.

作者信息

Frongillo F, Lirosi M C, Sganga G, Grossi U, Nure E, Avolio A W, Bianco G, Mariano G, Agnes S

机构信息

Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.

出版信息

Transplant Proc. 2014 Sep;46(7):2293-4. doi: 10.1016/j.transproceed.2014.07.057.

DOI:10.1016/j.transproceed.2014.07.057

PMID:25242772

Abstract

Ischemic-type biliary lesions (ITBLs) are now a discussed cause of morbidity and mortality in liver transplant recipients, even if not definitively characterized. We reviewed 13 years of donor and recipient data between April 2001 and April 2013. We evaluated the incidence of ITBL occurrence, exploring the possible predisposing factors, focusing on the relationship between severe macrovesicular steatosis of the graft and incidence of ITBL. A total of 445 grafts were harvested: 416 of them were transplanted at our institution, the remaining 29 were discarded by our donor team as showing more than 40% macrovesicular steatosis. Mild-moderate (20% to 40%) macrovesicular steatosis (P<.001) and cold ischemia time (P=.048) significantly increased the risk of ITBLs, also resulting in independent risk factors at multivariate analysis.

摘要

缺血型胆管病变（ITBLs）目前是肝移植受者发病和死亡的一个讨论焦点，即便其特征尚未完全明确。我们回顾了2001年4月至2013年4月间13年的供体和受体数据。我们评估了ITBL发生的发生率，探究可能的诱发因素，重点关注移植物严重大泡性脂肪变性与ITBL发生率之间的关系。共获取了445个移植物：其中416个在我们机构进行了移植，其余29个被我们的供体团队因显示超过40%的大泡性脂肪变性而丢弃。轻至中度（20%至40%）大泡性脂肪变性（P<0.001）和冷缺血时间（P = 0.048）显著增加了ITBL的风险，在多变量分析中也成为独立的风险因素。