Department of Liver Transplant, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan.
J Coll Physicians Surg Pak. 2021 Aug;31(8):897-902. doi: 10.29271/jcpsp.2021.08.897.
ABASTRACT Objective: To determine the frequency, risk factors, and management of hepatic arterial thrombosis (HAT) in recipients of living donor living transplantation.
Cohort study.
Department of Liver Transplant, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan, from 1st January 2019 to 31st July 2020.
Two hundred and forty living donor liver transplants (LDLT) recipients' data were evaluated. Frequencies of HAT were recorded, and various risk factors for the development of HAT were analysed by comparing HAT group (n = 12) and non-HAT group (n = 228). Management and outcome of HAT cases were also reviewed. Statistical analysis of this study was done with SPSS software version 21.
Out of 240 patients, 212 (88.3%) were males. Overall mean age was 39.40 ± 12.14 years. Mean model for end-stage liver disease (MELD) score was 18.70 ± 4.98. Overall male to female ratio was 7.5:1. The common indication for LDLT in these patients was chronic liver disease secondary to hepatitis B and C virus infection in 85% of patients. Postoperative HAT incidence was found as 5%. Risk factor found statistically significant was intraoperative platelet transfusion.
HAT is a deadly complication and needs early detection to avoid graft loss. The risk factor documented in this study should be avoided, if possible. Moreover, prompt and quick action is necessary for re-vascularisation to avoid re-transplantation. Key Words: Living donor, Hepatic arterial thrombosis, Liver transplantation.
摘要
确定活体供体活体肝移植受者肝动脉血栓形成(HAT)的频率、危险因素和处理方法。
队列研究。
巴基斯坦信德省甘巴特市皮儿阿卜杜勒·卡迪尔·沙赫·杰拉尼医科研究所肝移植科,2019 年 1 月 1 日至 2020 年 7 月 31 日。
评估了 240 例活体供肝移植受者的数据。记录 HAT 的频率,并通过比较 HAT 组(n=12)和非 HAT 组(n=228)分析 HAT 发展的各种危险因素。还回顾了 HAT 病例的处理和结果。本研究的统计分析采用 SPSS 软件版本 21。
240 例患者中,212 例(88.3%)为男性。总体平均年龄为 39.40±12.14 岁。平均终末期肝病模型(MELD)评分 18.70±4.98。总体男女比例为 7.5:1。这些患者行 LDLT 的常见指征是乙型和丙型肝炎病毒感染引起的慢性肝病,占 85%。术后 HAT 发生率为 5%。术中血小板输注是唯一有统计学意义的危险因素。
HAT 是一种致命的并发症,需要早期发现以避免移植物丢失。本研究中发现的危险因素应尽可能避免。此外,需要迅速采取行动进行再血管化以避免再次移植。
活体供者、肝动脉血栓形成、肝移植。