Guirguis Reginia Nabil, Nashaat Ehab Hasan, Yassin Azza Emam, Ibrahim Wesam Ahmed, Saleh Shereen A, Bahaa Mohamed, El-Meteini Mahmoud, Fathy Mohamed, Dabbous Hany Mansour, Montasser Iman Fawzy, Salah Manar, Mohamed Ghada Abdelrahman
Department of Internal Medicine, Gastroenterology and Hepatology Unit, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt.
Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt.
World J Hepatol. 2021 Oct 27;13(10):1405-1416. doi: 10.4254/wjh.v13.i10.1405.
Despite significant advancements in liver transplantation (LT) surgical procedures and perioperative care, post-LT biliary complications (BCs) remain a significant source of morbidity, mortality, and graft failure. In addition, data are conflicting regarding the health-related quality of life (HRQoL) of LT recipients. Thus, the success of LT should be considered in terms of both the survival and recovery of HRQoL.
To assess the impact of BCs on the HRQoL of live-donor LT recipients (LDLT-Rs).
We retrospectively analysed data for 25 LDLT-Rs who developed BCs post-LT between January 2011 and December 2016 at our institution. The Short Form 12 version 2 (SF 12v2) health survey was used to assess their HRQoL. We also included 25 LDLT-Rs without any post-LT complications as a control group.
The scores for HRQoL of LDLT-Rs who developed BCs were significantly higher than the norm-based scores in the domains of physical functioning ( = 0.003), role-physical ( < 0.001), bodily pain ( = 0.003), general health ( = 0.004), social functioning ( = 0.005), role-emotional ( < 0.001), and mental health ( < 0.001). No significant difference between the two groups regarding vitality was detected ( = 1.000). The LDLT-Rs with BCs had significantly lower scores than LDLT-Rs without BCs in all HRQoL domains ( < 0.001) and the mental ( < 0.001) and physical ( = 0.0002) component summary scores.
The development of BCs in LDLT-Rs causes a lower range of improvement in HRQoL.
尽管肝移植(LT)手术操作和围手术期护理取得了显著进展,但肝移植术后胆道并发症(BCs)仍然是发病、死亡和移植失败的重要原因。此外,关于肝移植受者健康相关生活质量(HRQoL)的数据存在矛盾。因此,肝移植的成功应从生存和HRQoL恢复两方面来考虑。
评估BCs对活体肝移植受者(LDLT-Rs)HRQoL的影响。
我们回顾性分析了2011年1月至2016年12月在我院接受LT后发生BCs的25例LDLT-Rs的数据。采用简短健康调查问卷第2版(SF 12v2)评估他们的HRQoL。我们还纳入了25例无LT术后任何并发症的LDLT-Rs作为对照组。
发生BCs的LDLT-Rs在身体功能(P = 0.003)、角色-身体(P < 0.001)、身体疼痛(P = 0.003)、总体健康(P = 0.004)、社会功能(P = 0.005)、角色-情感(P < 0.001)和心理健康(P < 0.001)领域的HRQoL得分显著高于基于常模的得分。两组在活力方面未检测到显著差异(P = 1.000)。发生BCs的LDLT-Rs在所有HRQoL领域(P < 0.001)以及心理(P < 0.001)和身体(P = 0.0002)成分汇总得分方面均显著低于无BCs的LDLT-Rs。
LDLT-Rs中BCs的发生导致HRQoL改善范围较低。