Sultanaliev Tokan, Zhexembayev Assan, Mukazhanov Adilbek, Zharkymbekov Bakhyt, Kuttymuratov Gani, Spatayev Zhanat, Ibrayev Bauyrzhan, Yesmembetov Kakharman, Ashimkhanova Aiymkul, Asykbayev Mels
From the JSC National Scientific Center for Oncology and Transplantology, Astana, Kazakhstan.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:120-2. doi: 10.6002/ect.tdtd2015.P66.
Kazakhstan is experiencing a high demand for liver transplants. More than 1000 patients have end-stage liver disease in the country, and liver transplant is the only viable option for their treatment.
Liver transplant patients, treated from February 2013 to December 2014, were included in this retrospective analysis.
From February 2013 to December 2014, seven patients received a liver transplant in our center (1 pediatric patient was excluded). Deceased liver recipients' (n = 3) median age was 52 years and median Model for End-Stage Liver Disease score 9. The indication for transplant was uncontrolled portal hypertension due to autoimmune liver disease. Cadaveric donors' median age was 45 years. Recipients' intensive care unit stay was > 5 days, time on inotropic support was > 3 days. Mean cold ischemic time was > 6 hours, and secondary ischemic time was 67 minutes. One patient in the deceased donor transplant group died during postoperative week 1 from hepatic artery thrombosis. Living donor liver recipients' (n = 3) median age was 47 years (43-48 y) and median Model for End-Stage Liver Disease score was 17 (range 14-20). Liver disease was hepatitis virus related (hepatitis C virus in 1 patient and hepatitis B and D virus in 2 patients). Mean cold ischemic time was 0.43 hours, and mean secondary ischemic time was 64 minutes. One recipient in the living donor liver group died early in the postoperative period from hemorrhage.
Our experience was insufficient to adequately assess morbidity and survival rates in patients for whom the longest follow-up was 25 months. However, no episodes of rejection were observed. Survival rates between living and deceased donor recipients were equivalent, although cadaveric-donor liver conditions were imperfect. This analysis demonstrates the necessity for timely diagnosis of surgical complications, which accounted for all mortality incidence in our series.
哈萨克斯坦对肝移植的需求很高。该国1000多名患者患有终末期肝病，肝移植是治疗他们的唯一可行选择。
本回顾性分析纳入了2013年2月至2014年12月接受治疗的肝移植患者。
2013年2月至2014年12月，7名患者在我们中心接受了肝移植（排除1名儿科患者）。已故肝受体（n = 3）的中位年龄为52岁，终末期肝病模型评分中位数为9分。移植指征为自身免疫性肝病导致的门静脉高压失控。尸体供体的中位年龄为45岁。受体在重症监护病房的停留时间> 5天，使用血管活性药物支持的时间> 3天。平均冷缺血时间> 6小时，二次缺血时间为67分钟。已故供体移植组的1名患者在术后第1周因肝动脉血栓形成死亡。活体供肝受体（n = 3）的中位年龄为47岁（43 - 48岁），终末期肝病模型评分中位数为17分（范围14 - 20）。肝病与肝炎病毒相关（1例患者为丙型肝炎病毒，2例患者为乙型和丁型肝炎病毒）。平均冷缺血时间为0.43小时，平均二次缺血时间为64分钟。活体供肝组的1名受体在术后早期因出血死亡。
我们的经验不足以充分评估随访时间最长为25个月的患者的发病率和生存率。然而，未观察到排斥反应事件。尽管尸体供肝情况不理想，但活体和已故供体受体的生存率相当。该分析表明及时诊断手术并发症的必要性,手术并发症是我们系列研究中所有死亡事件的原因。
