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冷缺血时间对肝移植肝功能的影响。

EFFECTS OF COLD ISCHEMIA TIME ON HEPATIC ALLOGRAFT FUNCTION.

作者信息

Freitas Alexandre Coutinho Teixeira de, Matos Desirée de Marillac Nascimento de, Milsted Jorge Amilton Tosato, Coelho Julio Cezar Uili

机构信息

Clinical Hospital Complex, Hepatic Transplantation Service.

Faculty of Medicine, Federal University of Paraná, Curitiba, PR, Brazil.

出版信息

Arq Bras Cir Dig. 2017 Oct-Dec;30(4):239-243. doi: 10.1590/0102-6720201700040003.

DOI:10.1590/0102-6720201700040003
PMID:29340545
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5793139/
Abstract

BACKGROUND

Cold ischemia time is related to success of liver transplantation.

AIM

To compare the impact of cold ischemia time on allografts locally collected to those collected distantly.

METHODS

Were evaluated 83 transplantations. The patients were divided in two groups: those who received liver grafts collected from cities out of Curitiba (n=42) and locally (n=41). From the donors were compared: cause of death, days at ICU, cardiac arrest, vasoactive drugs, lab exams, gender, age, and BMI. Were compared the subsequent information of receptors: cold ischemia time, warm ischemia time, length of surgery, lab exams, etiology of cirrhosis, MELD score, age, gender, histology of graft, use of vasoactive drugs, and blood components transfusion. Were evaluated the correlation between cold ischemia time and lab results.

RESULTS

The liver grafts collected from other cities were submitted to a longer cold ischemia time (500±145 min) compared to those locally collected (317,85±105 min). Donors from other cities showed a higher serum sodium level at donation (154±16 mEq/dl) compared to those from Curitiba (144±10 mEq/dl). The length of cold ischemia time was related to serum levels of ALT and total bilirubin.

CONCLUSION

Liver grafts distantly collected underwent longer cold ischemia times, although it caused neither histologic injuries nor higher transfusion demands. There is a correlation between cold ischemia time and hepatic injury, translated by elevation of serum ALT and total bilirubin levels.

摘要

背景

冷缺血时间与肝移植的成功相关。

目的

比较冷缺血时间对本地采集的同种异体移植物和远距离采集的同种异体移植物的影响。

方法

对83例肝移植进行评估。患者分为两组:接受从库里蒂巴市以外城市采集的肝移植患者(n = 42)和接受本地采集的肝移植患者(n = 41)。比较供体的以下指标:死亡原因、在重症监护病房的天数、心脏骤停、血管活性药物使用情况、实验室检查结果、性别、年龄和体重指数。比较受体的后续信息:冷缺血时间、热缺血时间、手术时长、实验室检查结果、肝硬化病因、终末期肝病模型(MELD)评分、年龄、性别、移植物组织学、血管活性药物使用情况和血液成分输血情况。评估冷缺血时间与实验室检查结果之间的相关性。

结果

与本地采集的肝移植相比,从其他城市采集的肝移植冷缺血时间更长(500±145分钟)。其他城市的供体在捐献时血清钠水平更高(154±16毫当量/升),而库里蒂巴的供体为(144±10毫当量/升)。冷缺血时间与谷丙转氨酶(ALT)和总胆红素的血清水平相关。

结论

远距离采集的肝移植冷缺血时间更长,尽管这既未造成组织学损伤,也未导致更高的输血需求。冷缺血时间与肝损伤之间存在相关性,表现为血清ALT和总胆红素水平升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d59/5793139/dbcb04647522/0102-6720-abcd-30-04-00239-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d59/5793139/6aaee8767ff7/0102-6720-abcd-30-04-00239-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d59/5793139/dbcb04647522/0102-6720-abcd-30-04-00239-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d59/5793139/6aaee8767ff7/0102-6720-abcd-30-04-00239-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d59/5793139/dbcb04647522/0102-6720-abcd-30-04-00239-gf2.jpg

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