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肝移植治疗布加综合征:一项具有挑战性但可处理的手术。

Liver transplantation for Budd-Chiari syndrome: A challenging but handable procedure.

机构信息

Department of Organ Transplantation, Acibadem Mehmet Ali Aydinlar Atakent University Hospital, Istanbul, Turkey.

Department of Organ Transplantation, Acibadem Mehmet Ali Aydinlar Atakent University Hospital, Istanbul, Turkey.

出版信息

Asian J Surg. 2022 Jul;45(7):1396-1402. doi: 10.1016/j.asjsur.2021.09.007. Epub 2021 Oct 28.

Abstract

BACKROUND

Establishing venous outflow in liver transplantation for patients with Budd-Chiari syndrome is crucial and requires various surgical techniques. The outcomes of these patients exibits distinct problems including vasculary thrombosis and biliary complications.

METHODS

In this single center study, the outcomes and surgical features of 33 patients with Budd-Chiari syndrome who were carried out liver translantation (27 patients from living donor). Another group was formed among patients underwent liver transplantation due to other etiologies and the outcomes were compared.

RESULTS

The most-seen type was the classical type of Budd-Chiari syndrome (25, 75.8%). For twenty-six patients inherited or acquired prothrombotic disorders were identified (78.2%) in Budd-Chiari group. Average follow-up was 29.7 ± 15.5 months. We have observed no recurrence of disease in our BCS patients. When the two groups was compared in terms of thrombotic complications, there was a significantly increased risk in BCS group (p = 0.014). Our 1 and 3-year survival rates for the BCS group were 81.8% and 78.8%, respectively. In the control group, 1 and 3-year survival rates were 93.3% and 88.9%, respectively. Log-rank test analyses showed no statistically significant results.

CONCLUSION

Liver transplantation with individual surgical and postoperative treatment strategy for patients with Budd-Chiari syndrome provides comparable outcomes.

摘要

背景

建立布加综合征患者肝移植中的静脉流出道至关重要,需要各种手术技术。这些患者的预后存在明显问题,包括血管血栓形成和胆道并发症。

方法

在这项单中心研究中,我们对 33 例布加综合征患者(27 例来自活体供体)进行了肝移植(LT),分析了他们的结局和手术特点。并与因其他病因接受 LT 的患者进行了比较。

结果

最常见的类型是经典型布加综合征(25 例,75.8%)。在布加综合征组中,有 26 例患者(78.2%)存在遗传性或获得性血栓形成倾向。平均随访时间为 29.7±15.5 个月。我们没有观察到布加综合征患者疾病复发。在血栓形成并发症方面,两组比较差异有统计学意义(p=0.014)。布加综合征组的 1 年和 3 年生存率分别为 81.8%和 78.8%,而对照组分别为 93.3%和 88.9%。Log-rank 检验分析显示无统计学差异。

结论

对布加综合征患者采用个体化的手术和术后治疗策略进行肝移植可获得相当的结局。

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