Department of Anaesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
BMC Gastroenterol. 2021 Nov 25;21(1):444. doi: 10.1186/s12876-021-02026-7.
Nowadays, liver transplantation has become a main therapy for end-stage liver disease. However, studies show that there are high mortality and severe complications after liver transplantation. Although gastrointestinal dysfunction is a common and major complication after liver transplantation, there was rarely relative research. This study aims to elucidate the factors about ileus after liver transplantation and patients' survival.
We collected and analyzed the data (n = 318, 2016-2019) from the First Affiliated Hospital of Xi'an Jiaotong University. After excluding cases, a total of 293 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. We reviewed 38 variables (including preoperative, operative and postoperative relative factors). Additionally, other complications after liver transplantation and survival data were compared between two groups.
Of the 293 patients, 23.2% (n = 68) experienced postoperative ileus. Ileus patients were not different with non-ileus patients in preoperative, operative and postoperative factors. HBV-positive patients with ileus had a lower MELD score (P = 0.025), and lower postoperative total bilirubin was correlated with ileus (P = 0.049). Besides, Child-Pugh score of HCC patients with ileus was low (P = 0.029). The complications after liver transplantation were not different between two groups. Compared with the patients without ileus, the patients with ileus had a higher mortality rate.
According to our research, ileus-patients had a lower 1-year survival rates. The preoperative MELD score and postoperative total bilirubin of HBV-positive patients with ileus were lower, and Child-Pugh score of HCC patients with ileus was also lower.
如今，肝移植已成为治疗终末期肝病的主要手段。然而，研究表明，肝移植后死亡率高，并发症严重。尽管胃肠功能障碍是肝移植后的常见且主要并发症，但相关研究很少。本研究旨在阐明肝移植后肠梗阻的相关因素及其对患者生存率的影响。
我们收集和分析了 2016 年至 2019 年西安交通大学第一附属医院的数据（n=318 例）。排除病例后，共有 293 例患者纳入本研究。将研究对象分为非肠梗阻组和肠梗阻组。我们回顾了 38 个变量（包括术前、术中、术后相关因素）。此外，还比较了两组患者肝移植后的其他并发症和生存数据。
在 293 例患者中，23.2%（n=68）发生术后肠梗阻。肠梗阻患者在术前、术中、术后因素方面与非肠梗阻患者无差异。HBV 阳性肠梗阻患者的 MELD 评分较低（P=0.025），术后总胆红素较低与肠梗阻有关（P=0.049）。此外，有肠梗阻的 HCC 患者的 Child-Pugh 评分较低（P=0.029）。两组患者肝移植后的并发症无差异。与无肠梗阻患者相比，有肠梗阻患者的死亡率更高。
根据我们的研究，肠梗阻患者的 1 年生存率较低。HBV 阳性肠梗阻患者的术前 MELD 评分和术后总胆红素较低，HCC 肠梗阻患者的 Child-Pugh 评分也较低。
