Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Transplant Proc. 2023 Nov;55(9):2164-2170. doi: 10.1016/j.transproceed.2023.07.029. Epub 2023 Sep 30.
This study aimed to elucidate the effect of early enteral nutrition on graft loss within 12 h after living-donor liver transplantation (LDLT) using propensity score-matching analysis and subsequently examine the risk factors for graft loss after LDLT.
We retrospectively reviewed the data of 467 LDLT patients who were assigned to the early and non-early groups based on the optimal cutoff value of 12 h for the starting time of early enteral nutrition after LDLT to predict graft loss.
The 1-year graft survival rate of the early group before propensity score-matching was 92.1%, whereas the 1-year graft survival rate of the non-early group was 86.2%. There was no significant difference between the 2 groups (P = .067). The incidences of early allograft dysfunction (EAD), small-for-size graft (SFSG) syndrome, acute cellular rejection (ACR), and sepsis were not statistically different between the 2 groups (P = .12, .91, .46, and .056, respectively). After propensity score-matching, the 1-year graft survival rate of the early group was 94.4%, whereas the 1-year graft survival rate of the non-early group was 85.4% (P = .034). The incidences of EAD, SFSG syndrome, and ACR were not statistically different between the 2 groups (P = .43, .81, and .24, respectively). However, the incidence of sepsis was statistically different between the 2 groups (non-early: 10.7% vs early: 3.6%, P = .038).
Early enteral nutrition within 12 h after LDLT may contribute to better graft survival in LDLT patients by preventing sepsis.
本研究旨在通过倾向评分匹配分析阐明活体肝移植（LDLT）后 12 小时内早期肠内营养对移植物丢失的影响，随后探讨 LDLT 后移植物丢失的危险因素。
我们回顾性分析了 467 例 LDLT 患者的数据，根据 LDLT 后早期肠内营养开始时间的最佳 12 小时截断值，将这些患者分为早期组和非早期组，以预测移植物丢失。
在进行倾向评分匹配之前，早期组的 1 年移植物存活率为 92.1%，而非早期组的 1 年移植物存活率为 86.2%。两组间无显著差异（P=0.067）。两组间早期移植物功能障碍（EAD）、小肝综合征（SFSG）、急性细胞排斥（ACR）和脓毒症的发生率无统计学差异（P=0.12、0.91、0.46 和 0.056）。经过倾向评分匹配后，早期组的 1 年移植物存活率为 94.4%，而非早期组的 1 年移植物存活率为 85.4%（P=0.034）。两组间 EAD、SFSG 综合征和 ACR 的发生率无统计学差异（P=0.43、0.81 和 0.24）。然而，两组间脓毒症的发生率存在统计学差异（非早期组：10.7%；早期组：3.6%，P=0.038）。
LDLT 后 12 小时内早期肠内营养可能通过预防脓毒症有助于改善 LDLT 患者的移植物存活率。
