Althonaian Nouf Abdulaziz, Alsaiari Alanoud Saleh, Almanea Weaam Ahmed, Alsubaie Norah Jezaa, Almuharimi Awatif Ali, Althubaiti Alaa, Altamimi Abdulrahman Rashed, Abdullah Khalid Omer, Ohali Wael Abdulaziz
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Department of Hepatobiliary Surgery and Liver Transplantation, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2019 Mar-Apr;30(2):359-364. doi: 10.4103/1319-2442.256843.
Living donor liver transplantation (LDLT) offers life to patients with end-stage liver disease. The balance between the benefit to the recipient and the risk to the donor plays a central role in justifying LDLT. However, the incidence rates of complications posttransplant differ widely. This study is designed to identify postoperative complications in LDLT in a tertiary care center King Abdulaziz Medical City (KAMC). This was a retrospective cohort study. All donors at KAMC between January 2003 and December 2015 were reviewed through a hospital database and patient charts to determine the postoperative complications based on the modified Clavien classification system. All donors were relatives of the recipients and assessed before the surgery. A total of 101 donors underwent LDLT: 75 were male and 26 were female, with a mean age of 27.7 ± 6.6. The breakdown of specific surgical procedures was as follows: 65 (64.3%) donors underwent right hepatic lobectomy, 31 (30.6%) underwent left lateral hepatectomy, three (2.97%) underwent extended right hepatectomy with the inclusion of the middle hepatic vein, and two (1.98%) underwent left hepatectomy. Postoperative complications were determined in 20 patients (19.8%), but no mortality was observed. Complications were reported in 14 (21.5%) right and six (19.4%) left lateral hepatectomy donors. A total of 12 patients had Grade I complications, six patients had Grade II complications, and Grade III complications were reported in two cases. The most frequent complications were upper limb weakness to brachial plexus neuropathy and mild bile leak. Life-threatening complications in our center have not been reported in LDLT; however, some donors may experience postoperative morbidity, which usually were mild and had a good prognosis.
活体供肝肝移植(LDLT)为终末期肝病患者带来了生机。受体获益与供体风险之间的平衡在证明LDLT的合理性方面起着核心作用。然而,移植后并发症的发生率差异很大。本研究旨在确定阿卜杜勒阿齐兹国王医疗城(KAMC)这一三级医疗中心LDLT术后的并发症。这是一项回顾性队列研究。通过医院数据库和患者病历对2003年1月至2015年12月期间KAMC的所有供体进行了回顾,以根据改良的Clavien分类系统确定术后并发症。所有供体均为受体的亲属,并在手术前进行了评估。共有101名供体接受了LDLT:75名男性,26名女性,平均年龄为27.7±6.6岁。具体手术方式如下:65名(64.3%)供体接受了右肝叶切除术,31名(30.6%)接受了左外叶肝切除术,3名(2.97%)接受了包括肝中静脉在内的扩大右肝切除术,2名(1.98%)接受了左肝切除术。20例患者(19.8%)出现了术后并发症,但未观察到死亡病例。右肝叶切除术供体中有14例(21.5%)报告了并发症,左外叶肝切除术供体中有6例(19.4%)报告了并发症。共有12例患者出现I级并发症,6例患者出现II级并发症,2例报告了III级并发症。最常见的并发症是臂丛神经病变导致的上肢无力和轻度胆漏。我们中心尚未报告LDLT中有危及生命的并发症;然而,一些供体可能会经历术后发病,通常病情较轻,预后良好。