Chu Kevin K W, Chan See Ching, Sin Sui Ling, Chan Albert C Y, Chok Kenneth S H, Cheng Ignatius K P, Lo Chung Mau
Department of Surgery, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, China.
Department of Surgery and State Key Laboratory for Liver Research, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
Hepatol Int. 2017 May;11(3):300-305. doi: 10.1007/s12072-017-9786-1. Epub 2017 Feb 7.
BACKGROUND/PURPOSE: Dyslipidemia is common in liver transplant recipients. This retrospective study investigates whether donors play a role.
Prospectively collected data of donors and recipients of deceased-donor liver transplantation (DDLT) and living-donor liver transplantation (LDLT) were reviewed. Total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein (HDL) and fasting glucose were compared between groups. HDL ≥1.6 mmol/L at 2 years after transplant was considered the marker of a favorable post-transplant lipid profile in recipients. Univariate and multivariate analyses were performed to identify predictive factors for this marker.
There were 85 DDLTs and 80 LDLTs. LDLT donors were younger (30 vs. 50 years, p < 0.001) and lighter (58.2 vs. 63.4 kg, p = 0.008) and had a lower body mass index (21.2 vs. 23.7, p < 0.001). The DDLT group had more fatty grafts (p = 0.001) and longer cold (375 vs. 103.5 min, p < 0.001) and warm (50.5 vs. 46 min, p = 0.034) ischemia. LDLT donors had lower fasting glucose (4.85 vs. 7.21 mmol/L, p < 0.001) and triglyceride (0.87 vs. 1.22 mmol/L, p = 0.016) but higher HDL (1.58 vs. 1.39 mmol/L, p = 0.022). LDLT recipients also had higher HDL at 1 year (1.48 vs. 1.28 mmol/L, p = 0.026) and 2 years (1.43 vs. 1.21 mmol/L, p = 0.008). Fourteen (16.5%) DDLT recipients and 27 (33.8%) LDLT recipients had HDL ≥1.6 mmol/L at 2 years. On multivariate analysis, donor HDL ≥1.6 mmol/L (RR 4.311, 95% CI 1.666-11.158, p = 0.003) and recipient body mass index <24 (RR 2.753, 95% CI 1.064-7.127, p = 0.037) were the two independent predictive factors.
LDLT recipients had better lipid profiles than DDLT recipients. The feature of high HDL level in donors was transferred to recipients.
背景/目的：血脂异常在肝移植受者中很常见。本回顾性研究调查供者是否起作用。
回顾前瞻性收集的尸体供肝肝移植（DDLT）和活体供肝肝移植（LDLT）供者及受者的数据。比较各组的总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白（HDL）和空腹血糖。移植后2年HDL≥1.6 mmol/L被视为受者移植后脂质谱良好的标志。进行单因素和多因素分析以确定该标志的预测因素。
有85例DDLT和80例LDLT。LDLT供者更年轻（30岁对50岁，p<0.001）、更轻（58.2 kg对63.4 kg，p = 0.008）且体重指数更低（21.2对23.7，p<0.001）。DDLT组有更多脂肪性移植物（p = 0.001），冷缺血时间更长（375分钟对103.5分钟，p<0.001）和热缺血时间更长（50.5分钟对46分钟，p = 0.034）。LDLT供者空腹血糖更低（4.85 mmol/L对7.21 mmol/L，p<0.001）和甘油三酯更低（0.87 mmol/L对1.22 mmol/L，p = 0.016）但HDL更高（1.58 mmol/L对1.39 mmol/L，p = 0.022）。LDLT受者在1年（1.48 mmol/L对1.28 mmol/L，p = 0.026）和2年（1.43 mmol/L对1.21 mmol/L，p = 0.008）时HDL也更高。14例（16.5%）DDLT受者和27例（33.8%）LDLT受者在2年时HDL≥1.6 mmol/L。多因素分析显示，供者HDL≥1.6 mmol/L（RR 4.311，95%CI 1.666 - 11.158，p = 0.003）和受者体重指数<24（RR 2.753，95%CI 1.064 - 7.127，p = 0.037）是两个独立的预测因素。
LDLT受者的脂质谱比DDLT受者更好。供者HDL水平高的特征传递给了受者。
