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公民逝世后器官捐献肝移植78例临床经验分析

兰川 张鸣 严律南 李波 曾勇 文天夫 徐明清 王文涛 杨家印

兰川, 张鸣, 严律南, 等. 公民逝世后器官捐献肝移植78例临床经验分析[J]. 器官移植, 2016, 7(4): 287-291. doi: 10.3969/j.issn.1674-7445.2016.04.008
引用本文: 兰川, 张鸣, 严律南, 等. 公民逝世后器官捐献肝移植78例临床经验分析[J]. 器官移植, 2016, 7(4): 287-291. doi: 10.3969/j.issn.1674-7445.2016.04.008
Lan Chuan, Zhang Ming, Yan Lyunan, et al. Clinical experience analysis of liver transplantation from donation after citizen's death in 78 cases[J]. ORGAN TRANSPLANTATION, 2016, 7(4): 287-291. doi: 10.3969/j.issn.1674-7445.2016.04.008
Citation: Lan Chuan, Zhang Ming, Yan Lyunan, et al. Clinical experience analysis of liver transplantation from donation after citizen's death in 78 cases[J]. ORGAN TRANSPLANTATION, 2016, 7(4): 287-291. doi: 10.3969/j.issn.1674-7445.2016.04.008

公民逝世后器官捐献肝移植78例临床经验分析

doi: 10.3969/j.issn.1674-7445.2016.04.008
基金项目: 

国家科技部十二五重大专项 2012ZX10002-016

详细信息
    通讯作者:

    徐明清,Email:xumingqing0018@163.com

  • 中图分类号: R617

Clinical experience analysis of liver transplantation from donation after citizen's death in 78 cases

  • 摘要:   目的  总结公民逝世后器官捐献肝移植的临床经验及疗效分析。   方法  回顾性分析2012年3月至2015年11月四川大学华西医院肝脏移植中心完成的公民逝世后器官捐献供体肝移植的76例供体和78例受体的临床资料。观察肝移植受体早期移植物功能恢复情况并分析引起早期移植物功能障碍(EAD)的危险因素,观察远期的移植物生存及受体生存情况、并发症发生情况。   结果  78例受体术后EAD的发生率为36%(28/78),其中供体总胆红素(TB)高和冷缺血时间长是EAD发生的危险因素。受者围手术期存活率为92%(72/78),死亡6例,分别死于原发性移植物失功4例、上消化道大出血1例、肺部感染1例。术后发生腹腔感染5例,胆道狭窄3例,血管血栓形成2例,除1例死亡外,其余经相应治疗后好转。受体术后1年的存活率为84.2%,2年存活率为80.0%。   结论  公民逝世后器官捐献供肝是较好的供肝来源,其近远期效果良好。控制术前供肝质量,缩短冷缺血时间等均是提高临床效果的重要措施。

     

  • 表  1  术后发生早期移植物功能障碍的危险因素分析结果

    Table  1.   Analysis results of risk factors for early allograft dysfunction after transplantation

    危险因素 na EAD发生率[%(n/n)] P
    供体年龄
    ≥50岁 17 41(7/17) 0.728
    <50岁 61 34(21/61)
    供体BMI
    ≥25 kg/m2 5 4/5 0.200
    <25 kg/m2 73 33(24/73)
    供体TB
    ≥34.2 μmol/L 10 90(9/10) 0.028
    <34.2 μmol/L 68 28(19/68)
    供体ICU住院时间
    ≥5 d 12 33(4/12) 0.889
    <5 d 66 36(24/66)
    供体热缺血时间
    ≥15 min 43 42(18/43) 0.400
    <15 min 35 29(10/35)
    供体冷缺血时间
    ≥14 h 18 67(12/18) 0.046
    <14 h 60 27(16/60)
    受体年龄
    ≥55岁 18 28(5/18) 0.565
    <55岁 60 38(23/60)
    受体MELD评分
    ≥30 19 37(7/19) 0.946
    <30 59 36(21/59)
    受体手术时间
    ≥10 h 14 64(9/14) 0.118
    <10 h 64 30(19/64)
    受体接受供肝类型
    儿童供肝 20 30(6/20) 0.657
    成人供肝 58 38(22/58)
    注:na指供肝数量
    下载: 导出CSV
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出版历程
  • 收稿日期:  2016-03-20
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2016-07-15

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