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活体肝切除术后供体并发症:日本某机构单一团队的17年经验

Donor Complications Following Living Donor Hepatectomy: 17-Year Experience of a Single Team in One Institution of Japan.

作者信息

Kadohisa Masashi, Inomata Yukihiro, Shimata Keita, Isono Kaori, Honda Masaki, Hayashida Shintaro, Ohya Yuki, Yamamoto Hidekazu, Okajima Hideaki, Hibi Taizo

机构信息

From the Department of Transplantation and Pediatric Surgery, Kumamoto University, Kumamoto, Japan; and the Department of Pediatric Surgery, Kyoto University, Kyoto, Japan.

出版信息

Exp Clin Transplant. 2024 Mar;22(3):223-228. doi: 10.6002/ect.2024.0026.

Abstract

OBJECTIVES

Donor safety is paramount in living donor liver transplantation. However, there remains a risk of postoperative complications for some donors. Here, we provide a comprehensive assessment of donor morbidity by a single team with 17 years of experience at a single center.

MATERIALS AND METHODS

We retrospectively reviewed 453 donor hepatectomies of living donor liver transplants at Kumamoto University from August 2000 to March 2017. Posterior segment graft cases were excluded in this study.

RESULTS

The donors were classified by graft type as follows: right lobe (n = 173), left lobe (n = 149), and left lateral segment (n = 131). The overall complication rate was 29.8%, and the severe complication (Clavien-Dindo grade IIIa or higher) rate was 9.1%. The most frequent complication was bile leakage, with an overall incidence of 13.9% and severe incidence of 4.6%. Among the 3 types of graft, there were no significant differences in bile leakage with any Clavien-Dindo grade. However, upper gastrointestinal complications, such as a duodenal ulcer and gastric stasis, were related to left lobe donation.

CONCLUSIONS

There were no significant differences in the incidence of postoperative donor complications, except upper gastrointestinal complications, among the 3 types of graft.

摘要

目的

供体安全在活体肝移植中至关重要。然而,部分供体术后仍存在发生并发症的风险。在此,我们由一个在单一中心拥有17年经验的团队对供体的发病情况进行了全面评估。

材料与方法

我们回顾性分析了2000年8月至2017年3月在熊本大学进行的453例活体肝移植供体肝切除术。本研究排除了后段移植病例。

结果

供体按移植类型分类如下:右叶(n = 173)、左叶(n = 149)和左外侧段(n = 131)。总体并发症发生率为29.8%,严重并发症(Clavien-Dindo分级IIIa级或更高)发生率为9.1%。最常见的并发症是胆漏,总体发生率为13.9%,严重发生率为4.6%。在3种移植类型中,任何Clavien-Dindo分级的胆漏发生率均无显著差异。然而,十二指肠溃疡和胃潴留等上消化道并发症与左叶供肝有关。

结论

除上消化道并发症外,3种移植类型的供体术后并发症发生率无显著差异。

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