Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey.
Clin Transplant. 2018 Jun;32(6):e13262. doi: 10.1111/ctr.13262. Epub 2018 May 10.
To determine the relationship between a transplant center's experience and life-threatening or nearly life-threatening complications during living donor hepatectomy (LDH).
The medical records of 1140 patients who underwent LDH were analyzed. To determine the relationship between life-threatening complications and a transplant center's experience, the following comparisons between LDH cases were performed: first 100 vs subsequent 100; first 100 vs subsequent 1040; first 200 vs subsequent 940; right hepatectomy vs left hepatectomy; and first 5 years of experience vs subsequent 5 years.
A total of 36 life-threatening or nearly life-threatening complications developed in 34 of 1140 (2.98%) healthy individuals undergoing LDH. Of these, 5 occurred intraoperatively, 26 within 1 month, and 5 beyond 1 month. The most common complications were biliary problems and postoperative bleeding. None of the donors died at follow-up. One donor underwent deceased donor liver transplantation (DDLT) for severe hepatic failure. Only 2 comparisons were significantly different with regard to life-threatening complications: the first 100 vs the subsequent 1040 (P = .03) and the first 200 vs the subsequent 940 (P = .01).
This study indicates that the incidence of life-threatening or nearly life-threatening complications are reduced by increased center experience (>200 LDHs).
确定移植中心经验与活体供肝切除术（LDH）期间危及生命或几乎危及生命的并发症之间的关系。
分析了 1140 例接受 LDH 的患者的病历。为了确定危及生命的并发症与移植中心经验之间的关系，对 LDH 病例进行了以下比较：前 100 例与后 100 例；前 100 例与后 1040 例；前 200 例与后 940 例；右半肝切除术与左半肝切除术；以及前 5 年经验与后 5 年经验。
在 1140 例健康个体接受 LDH 的过程中，共有 36 例发生危及生命或几乎危及生命的并发症，其中 34 例发生于 36 例。其中，5 例发生在术中，26 例发生在术后 1 个月内，5 例发生在术后 1 个月以上。最常见的并发症是胆道问题和术后出血。在随访期间，没有供者死亡。有 1 名供者因严重肝衰竭而行 deceased donor liver transplantation (DDLT)。只有 2 项比较在危及生命的并发症方面有显著差异：前 100 例与后 1040 例（P =.03），以及前 200 例与后 940 例（P =.01）。
本研究表明，随着中心经验的增加（>200 例 LDH），危及生命或几乎危及生命的并发症发生率降低。
