小儿脑死亡供体肝移植中肝动脉血栓形成的危险因素

Risk factors of hepatic artery thrombosis in pediatric deceased donor liver transplantation.

作者信息

Ma Nan, Song Zhuolun, Dong Chong, Sun Chao, Meng Xingchu, Zhang Wei, Wang Kai, Wu Bin, Li Shanni, Qin Hong, Han Chao, Li Haohao, Gao Wei, Shen Zhongyang

机构信息

Organ Transplantation Center, Tianjin First Center Hospital, No. 24 Fukang Road, Nankai District, 300192, Tianjin, People's Republic of China.

Tianjin Key Laboratory for Organ Transplantation, Tianjin, People's Republic of China.

出版信息

Pediatr Surg Int. 2019 Aug;35(8):853-859. doi: 10.1007/s00383-019-04500-6. Epub 2019 Jun 15.

DOI:10.1007/s00383-019-04500-6

PMID:31203384

Abstract

PURPOSE

Hepatic artery thrombosis (HAT) remains a life-threatening complication in liver transplantation. We aim to investigate the risk factors of HAT in deceased donor pediatric liver transplantation.

METHODS

104 recipients from 2014 to 2016 were enrolled; donor and recipient characteristics, surgical variables, graft and recipient survival rate were compared between recipients with or without HAT. Univariate and multivariate analysis were applied to identify the risk factors of HAT.

RESULTS

The recipient survival rate was 87.0% and 96.3% at 1 year, and 87.0% and 96.3% at 3 years in HAT and non-HAT groups without significant difference. The graft survival rate was 73.9% and 96.3% at 1 year, and 73.9% and 95.1% at 3 years in HAT and non-HAT groups; significant difference was observed between two groups at both 1 and 3 years. Donor age less than 8.5 months, graft weight less than 190 g and GRWR less than 2.2% were identified as independent risk factors for HAT. Recipients with HAT were associated with higher incidence of post-operative biliary complications.

CONCLUSIONS

Young donor age and small liver graft are risk factors for HAT in deceased donor pediatric liver transplantation.

摘要

目的

肝动脉血栓形成（HAT）仍是肝移植中危及生命的并发症。我们旨在研究小儿尸体供肝肝移植中HAT的危险因素。

方法

纳入2014年至2016年的104例受者；比较发生或未发生HAT的受者之间的供体和受者特征、手术变量、移植物和受者生存率。采用单因素和多因素分析确定HAT的危险因素。

结果

HAT组和非HAT组1年时受者生存率分别为87.0%和96.3%，3年时分别为87.0%和96.3%，无显著差异。HAT组和非HAT组1年时移植物生存率分别为73.9%和96.3%，3年时分别为73.9%和95.1%；两组在1年和3年时均观察到显著差异。供体年龄小于8.5个月、移植物重量小于190 g和移植物重量与受体体重比（GRWR）小于2.2%被确定为HAT的独立危险因素。发生HAT的受者术后胆道并发症发生率较高。