Ulubay Gaye, Er Dedekarginoglu Balam, Kupeli Elif, Salman Sever Ozlem, Oner Eyuboglu Fusun, Haberal Mehmet
From the Department of Pulmonary Diseases, Baskent University, Ankara, Turkey.
Exp Clin Transplant. 2015 Apr;13 Suppl 1:340-5. doi: 10.6002/ect.mesot2014.p183.
Living-donor liver transplant has become a viable option and an important source of hepatic grafts. The goal of this study is to establish postoperative pulmonary complications of liver donation surgery in our center.
Data from 188 subjects (median age, 33.7 ± 8.4 y; male/female, 51.1%/48.9%) who had liver donation surgery from 1988 to 2013 were analyzed retrospectively. Patient demographic and clinical features were recorded. Postoperative complications and the correlation of risk factors for postoperative pulmonary complications were investigated.
The incidence of early postoperative complications was 17% (n = 32), and 16 of these patients had postoperative pulmonary complications (8.5%); 2 of the postoperative pulmonary complications were detected on the day of surgery and the other 14 complications were observed between the second and seventh day after surgery. Most postoperative pulmonary complications were minor complications including atelectasis, pleural effusion, and pneumonia. There was 1 major postoperative pulmonary complication: pulmonary embolism that occurred on the fourth day after surgery in 1 patient. Late pulmonary complications also were reviewed and no late postoperative pulmonary complications were observed. There was no significant difference in early and late postoperative pulmonary complications between ex-smokers and smokers. Postoperative atelectasis was significantly higher in patients with body mass index ≤ 20 kg/m ² than patients with body mass index > 21 kg/m ² (P = .027). In our study population, no postoperative mortality was recorded.
We believe that preoperative weight reduction strategies and early mobilization with postoperative respiratory physiotherapy could be important factors to reduce postoperative pulmonary complications in liver donors.
活体肝移植已成为一种可行的选择和肝脏移植物的重要来源。本研究的目的是确定我们中心肝脏供体手术的术后肺部并发症。
回顾性分析1988年至2013年期间接受肝脏供体手术的188例患者（中位年龄33.7±8.4岁；男性/女性，51.1%/48.9%）的数据。记录患者的人口统计学和临床特征。调查术后并发症以及术后肺部并发症的危险因素相关性。
术后早期并发症的发生率为17%（n = 32），其中16例患者出现术后肺部并发症（8.5%）；2例术后肺部并发症在手术当天被发现，其他14例并发症在术后第二天至第七天被观察到。大多数术后肺部并发症为轻微并发症，包括肺不张、胸腔积液和肺炎。有1例术后严重肺部并发症：1例患者在术后第四天发生肺栓塞。还对晚期肺部并发症进行了评估，未观察到晚期术后肺部并发症。既往吸烟者和吸烟者在术后早期和晚期肺部并发症方面无显著差异。体重指数≤20 kg/m²的患者术后肺不张发生率显著高于体重指数>21 kg/m²的患者（P = 0.027）。在我们的研究人群中，未记录到术后死亡病例。
我们认为术前减重策略以及术后早期活动和呼吸物理治疗可能是降低肝脏供体术后肺部并发症的重要因素。
