[心脏死亡后供体肝移植术后胆系并发症的危险因素]

[Risk factors of biliary complications after liver transplantation from donation after cardiac death].

作者信息

Yu Jun, Xie Shang-Fen, Xia Wei-Liang, Cheng Long-Yu, Zhang Wu, Yu Song-Feng, Zhang Min, Zheng Shu-Sen

机构信息

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine；Key Laboratory of Combined Multi-organ Transplantation, Ministry of Health; Key Laboratory of Organ Transplantation, Zhejiang Province, Hangzhou 310003, China.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2014 Nov;43(6):664-9. doi: 10.3785/j.issn.1008-9292.2014.11.005.

DOI:10.3785/j.issn.1008-9292.2014.11.005

PMID:25644565

Abstract

OBJECTIVE

To analyze the risk factors for biliary complications of liver transplantation from donation after cardiac death (DCD).

METHODS

Clinical data of 109 patients undergoing liver transplantation from DCD in First Affiliated Hospital of Zhejiang University School of Medicine from October 2010 to October 2013 were studied retrospectively. The risk factors of biliary complications following DCD liver transplantation were analyzed.

RESULTS

Twenty-four (22%) patients developed biliary complications after DCD liver transplantation. Univariate analysis showed that biliary complications were associated with warm ischemia time (P<0.001) and length of ICU stay (P=0.013), but not associated with ABO blood types match (P>0.05). Administration of inotropic agents and fatty liver increased the trend of biliary complications. Multivariate analysis demonstrated that warm ischemia time and length of ICU stay were independent risk factors for predicting biliary complications.

CONCLUSION

Warm ischemia time and days of ICU stay are independent risk factors for predicting biliary complications after DCD liver transplantation.

摘要

目的

分析心脏死亡后器官捐献（DCD）肝移植术后胆道并发症的危险因素。

方法

回顾性研究2010年10月至2013年10月在浙江大学医学院附属第一医院接受DCD肝移植的109例患者的临床资料。分析DCD肝移植术后胆道并发症的危险因素。

结果

24例（22%）患者在DCD肝移植术后发生胆道并发症。单因素分析显示，胆道并发症与热缺血时间（P<0.001）和ICU住院时间（P=0.013）相关，但与ABO血型匹配无关（P>0.05）。使用血管活性药物和脂肪肝会增加胆道并发症的发生趋势。多因素分析表明，热缺血时间和ICU住院时间是预测胆道并发症的独立危险因素。