在尸体供肝移植前使用呼吸机支持会增加移植后早期移植物功能衰竭的风险。
Ventilator support in the pretransplant period predisposes early graft failure after deceased donor liver transplantation.
作者信息
Lee Nuri, Cha Sora, Kim Jongman, Lee Yunmi, Kang Enjin, Kim Hyun Jung, Hong Seung Hui, Rhu Jinsoo, Choi Gyu-Seong, Joh Jae-Won
机构信息
Department of Surgery, Veterans Health Service Medical Center, Seoul, Korea.
Organ Transplant Center, Samsung Medical Center, Seoul, Korea.
出版信息
Ann Surg Treat Res. 2023 Sep;105(3):141-147. doi: 10.4174/astr.2023.105.3.141. Epub 2023 Sep 1.
PURPOSE
Deceased donor liver transplantation (DDLT) recipients in Korea are generally sicker due to an increasing organ shortage. In the present study, the risk factors for early 30-day liver graft failure after DDLT were identified.
METHODS
From August 2017 to February 2021, 265 adult DDLTs were performed. The characteristics of patients with and without 30-day graft failure were compared.
RESULTS
Liver graft failure occurred in 11 patients (17.7%) after DDLT. Baseline and perioperative characteristics of donors and recipients were not statistically significantly different between the 2 groups. The cumulative graft and overall survival rates at 6 months were 83.9% and 88.7%, respectively. Multivariate analysis showed ventilator support in the pretransplant period was a predisposing factor for 30-day graft failure after DDLT.
CONCLUSION
Present study indicates that cautious decision is required when allocating DDLT in critically ill patients on mechanical ventilatory support.
目的
由于器官短缺日益严重，韩国的已故供体肝移植（DDLT）受者通常病情更重。在本研究中，确定了DDLT后30天内早期肝移植失败的危险因素。
方法
2017年8月至2021年2月，进行了265例成人DDLT。比较了有和没有30天移植失败的患者的特征。
结果
DDLT后11例患者（17.7%）发生肝移植失败。两组之间供体和受体的基线及围手术期特征在统计学上无显著差异。6个月时的累积移植存活率和总生存率分别为83.9%和88.7%。多变量分析显示，移植前使用呼吸机支持是DDLT后30天移植失败的一个诱发因素。
结论
本研究表明，在为接受机械通气支持的重症患者分配DDLT时，需要谨慎决策。
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