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设拉子移植中心对血清转氨酶水平升高的已故供体肝脏进行的移植

Transplantation of Deceased Donor Livers With Elevated Levels of Serum Transaminases at Shiraz Transplant Center.

作者信息

Fakhar Nasir, Nikeghbalian Saman, Kazemi Kourosh, Shamsayeefar Ali Reza, Gholami Siavash, Kasraianfard Amir, Malek-Hosseini Seyed Ali

机构信息

Department of Surgery, Shiraz Center for Organ Transplantation, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Department of Surgery, Hamadan University of Medical Sciences, Hamadan, IR Iran.

出版信息

Hepat Mon. 2016 Oct 8;16(10):e40140. doi: 10.5812/hepatmon.40140. eCollection 2016 Oct.

Abstract

BACKGROUND

The current organ shortage has prompted the use of marginal organs. We conducted this retrospective study to present our experience with transplanting deceased donor livers with elevated levels of serum transaminases and to explain whether elevated levels of serum transaminases in donors affect allograft function and survival of the recipients.

METHODS

Data of deceased donor livers and patients, who underwent liver transplantation from March 2013 to March 2015 at Shiraz center for organ transplantation, was reviewed. Liver donors with aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) level of more than 500 IU/l and their related recipients were considered as the case group (n = 24) and the others were considered as the control group (n = 834).

RESULTS

In the case group, the medians of levels of serum AST and ALT of donors were 834 ± 425 IU/L (range: 250 - 2285) and 507 ± 367 IU/L (range: 100 - 1600), respectively. Recipients were followed for a median of 13.6 ± 9 months (range: 7 - 28.4). Post-transplant complications were acute rejection (n = 5), infection (n = 3), portal vein thrombosis (n = 3), bile duct stricture (n = 1), and hepatic artery stenosis (n = 1). The one-year survival rate of the patients was 91.7%. Demographics, post-transplant complications and one-year survival rates were not significantly different between the two study groups.

CONCLUSIONS

Transplanting deceased donor livers with markedly elevated liver enzymes may be an acceptable choice for expanding the donor pool.

摘要

背景

当前器官短缺促使人们使用边缘器官。我们开展这项回顾性研究,以展示我们移植血清转氨酶水平升高的已故供体肝脏的经验,并解释供体血清转氨酶水平升高是否会影响移植肝功能及受者存活情况。

方法

回顾了2013年3月至2015年3月在设拉子器官移植中心接受肝移植的已故供体肝脏及患者的数据。天冬氨酸转氨酶(AST)和/或丙氨酸转氨酶(ALT)水平超过500 IU/L的肝脏供体及其相关受者被视为病例组(n = 24),其他则被视为对照组(n = 834)。

结果

病例组中,供体血清AST和ALT水平的中位数分别为834 ± 425 IU/L(范围:250 - 2285)和507 ± 367 IU/L(范围:100 - 1600)。对受者进行了中位数为13.6 ± 9个月(范围:7 - 28.4)的随访。移植后并发症包括急性排斥反应(n = 5)、感染(n = 3)、门静脉血栓形成(n = 3)、胆管狭窄(n = 1)和肝动脉狭窄(n = 1)。患者的一年生存率为91.7%。两个研究组在人口统计学、移植后并发症和一年生存率方面无显著差异。

结论

移植肝酶明显升高的已故供体肝脏可能是扩大供体库的一个可接受选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e94/5116126/94a1f655f236/hepatmon-16-10-40140-i001.jpg

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