肝移植中的老年供体在围手术期过程与理想的年轻供体相当。

Octogenarian donors in liver transplantation grant an equivalent perioperative course to ideal young donors.

作者信息

Biancofiore Gianni, Bindi Maria, Ghinolfi Davide, Lai Quirino, Bisa Massimo, Esposito Massimo, Meacci Luca, Mozzo Roberto, Spelta Alicia, Filipponi Franco

机构信息

Anaesthesia and Critical Care for General and Transplantation Surgery, Azienda Ospedaliera-Universitaria Pisana, Italy.

出版信息

Dig Liver Dis. 2017 Jun;49(6):676-682. doi: 10.1016/j.dld.2017.01.149. Epub 2017 Jan 21.

DOI:10.1016/j.dld.2017.01.149

PMID:28179097

Abstract

BACKGROUND

Use of grafts from very old donors for liver transplantation is controversial.

AIM

To compare the perioperative course of patients receiving liver grafts from young ideal vs octogenarian donors.

METHODS

Analysis of the perioperative course of patients receiving liver grafts from young, ideal (18-39 years) vs octogenarian (≥80years) deceased donors between 2001 and 2014.

RESULTS

346 patients were studied: 179 (51.7%) received grafts aged 18-39 years whereas 167 (48.3%) received a graft from a donor aged ≥80years. Intra-operative cardiovascular (p=0.2), coagulopathy (p=0.5) and respiratory (p=1.0) complications and incidence of reperfusion syndrome (p=0.3) were similar. Patients receiving a young graft required more fresh frozen plasma units (p≤0.03) but did not differ for the need of packed red cells (p=0.2) and platelet (p=0.3) transfusions. Median ICU stay was identical (p=0.4). Patients receiving octogenarian vs young grafts did not differ in terms of death or re-transplant (p=1.0) during the ICU stay. Similar cardiovascular, respiratory, renal, infectious and neurological postoperative complication rates were observed in the two groups.

CONCLUSIONS

Octogenarian donors in liver transplantation grant an equivalent perioperative course to ideal young donors.

摘要

背景

使用来自高龄供体的移植物进行肝移植存在争议。

目的

比较接受来自年轻理想供体与八旬老人供体肝脏移植物患者的围手术期过程。

方法

分析2001年至2014年间接受来自年轻、理想（18 - 39岁）与八旬老人（≥80岁）已故供体肝脏移植物患者的围手术期过程。

结果

共研究了346例患者：179例（51.7%）接受了18 - 39岁供体的移植物，而167例（48.3%）接受了来自≥80岁供体的移植物。术中心血管（p = 0.2）、凝血功能障碍（p = 0.5）和呼吸（p = 1.0）并发症以及再灌注综合征发生率（p = 0.3）相似。接受年轻移植物的患者需要更多单位的新鲜冰冻血浆（p≤0.03），但在输注浓缩红细胞（p = 0.2）和血小板（p = 0.3）需求方面无差异。重症监护病房（ICU）中位住院时间相同（p = 0.4）。接受八旬老人供体与年轻供体移植物的患者在ICU住院期间死亡或再次移植方面无差异（p = 1.0）。两组术后心血管、呼吸、肾脏、感染和神经并发症发生率相似。