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与肝动脉血栓形成相关的危险因素:1050 例肝移植分析。

RISK FACTORS ASSOCIATED WITH HEPATIC ARTERY THROMBOSIS: ANALYSIS OF 1050 LIVER TRANSPLANTS.

机构信息

Department of Surgery, Federal University of Ceará, Fortaleza, CE, Brazil.

Department of Surgery, Federal University of Maranhão, São Luís, MA, Brazil.

出版信息

Arq Bras Cir Dig. 2021 Jan 25;33(4):e1556. doi: 10.1590/0102-672020200004e1556. eCollection 2021.

Abstract

BACKGROUND

Hepatic artery thrombosis is an important cause of graft loss and ischemic biliary complications. The risk factors have been related to technical aspects of arterial anastomosis and non-surgical ones.

AIM

To evaluate the risk factors for the development of hepatic artery thrombosis.

METHODS

The sample consisted of 1050 cases of liver transplant. A retrospective and cross-sectional study was carried out, and the variables studied in both donor and recipient.

RESULTS

Univariate analysis indicated that the variables related to hepatic artery thrombosis are: MELD (p=0.04) and warm time ischemia (p=0.005). In the multivariate analysis MELD=14.5 and warm ischemia time =35 min were independent risk factors for hepatic artery thrombosis. In the prevalence ratio test for analysis of the anastomosis as a variable, it was observed that patients with continuous suture had an increase in thrombosis when compared to interrupted suture.

CONCLUSIONS

Prolonged warm ischemia time, calculated MELD and recipient age were independent risk factors for hepatic artery thrombosis after liver transplantation in adults. Transplanted patients with continuous suture had an increase in thrombosis when compared to interrupted suture. Re-transplantation due to hepatic artery thrombosis was associated with higher recipient mortality.

摘要

背景

肝动脉血栓形成是移植物丢失和缺血性胆系并发症的重要原因。其危险因素与动脉吻合的技术方面和非手术方面有关。

目的

评估发生肝动脉血栓形成的危险因素。

方法

该样本由 1050 例肝移植组成。进行了回顾性和横断面研究,并研究了供体和受者的变量。

结果

单因素分析表明,与肝动脉血栓形成相关的变量是:MELD(p=0.04)和热缺血时间(p=0.005)。在多因素分析中,MELD=14.5 和热缺血时间=35 分钟是肝动脉血栓形成的独立危险因素。在吻合术作为变量的比值比检验分析中,观察到连续缝合的患者与间断缝合相比,血栓形成增加。

结论

成人肝移植后,长时间的热缺血时间、计算的 MELD 和受者年龄是肝动脉血栓形成的独立危险因素。与间断缝合相比,连续缝合的移植患者血栓形成增加。由于肝动脉血栓形成而再次移植与受者死亡率升高有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdd1/7836077/a71a49fc770e/0102-6720-abcd-33-04-e1556-gf1.jpg

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