İstanbul Aydın University, Medikalpark Florya Hospital, Organ Transplantation Center, Küçükçekmece, İstanbul.
Transplant Proc. 2024 Sep;56(7):1607-1612. doi: 10.1016/j.transproceed.2024.08.015. Epub 2024 Aug 26.
Complications and comorbidities that may develop after living donor liver transplantation may necessitate rehospitalization after discharge. We aimed to investigate the demographic and clinical factors affecting rehospitalization after discharge.
Two hundred seventy patients who underwent living-donor liver transplantation (LDLT) for end-stage liver cirrhosis were included in the study. Patients were divided into two groups as readmission group and others for statistical analysis. Age, gender, body mass index (BMI), model for end-stage liver disease (MELD), Child scores, etiology, blood product transfusion, anhepatic phase, cold ischemia time, operation time, graft-to-recipient weight ratio (GRWR), the type of recipient hepatic artery and hepatic vein utilized in the anastomoses, presence of liver segment 5, segment 8 and inferior accessory hepatic vein, presence of thrombosed, single or reconstructed portal vein, number of bile ducts, use of right, left/left lateral segment graft, postoperative intensive care unit and total hospitalization durations, surgical complications such as leakage/stricture, postoperative portal vein thrombosis, postoperative hepatic vein thrombosis, primary graft dysfunction, intra-abdominal hemorrhage, and postoperative early reoperation were statistically analyzed for readmission. In addition, patients with rehospitalization and others were statistically compared in terms of mortality and survival.
There was no statistical difference among etiologic factors, demographic findings, decompensation findings, comorbidities, perioperative findings, hospital durations, mortality, and survival (P > .05). Only patients with bile leakage/stricture had a statistically higher rehospitalization rate (P = .000).
Biliary complications are the most frequent cause of hospital rehospitalization following living donor liver transplantation.
活体供肝移植后可能出现的并发症和合并症可能需要在出院后再次住院。我们旨在研究影响出院后再次住院的人口统计学和临床因素。
本研究纳入了 270 例因终末期肝硬化而行活体供肝移植（LDLT）的患者。将患者分为再入院组和其他组进行统计分析。年龄、性别、体重指数（BMI）、终末期肝病模型（MELD）评分、Child 评分、病因、输血、无肝期、冷缺血时间、手术时间、供受体体重比（GRWR）、吻合时使用的受体肝动脉和肝静脉类型、肝段 5、8 和下副肝静脉的存在、血栓形成、单支或重建门静脉、胆管数量、使用右半肝、左/左外侧段肝、术后重症监护病房和总住院时间、手术并发症如漏/狭窄、术后门静脉血栓形成、术后肝静脉血栓形成、原发性移植物功能障碍、腹腔内出血和术后早期再次手术等进行统计分析。此外，对再入院患者和其他患者的死亡率和生存率进行了统计学比较。
病因、人口统计学、失代偿发现、合并症、围手术期发现、住院时间、死亡率和生存率方面无统计学差异（P >.05）。只有发生胆漏/狭窄的患者再入院率有统计学意义（P =.000）。
胆漏/狭窄是活体供肝移植后再次住院的最常见原因。
