Analysis of clinical effects of elderly donor liver from organ donation after citizen's death in liver transplantation: a single-center experience
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摘要:
目的 探讨高龄边缘供肝用于临床肝移植的临床疗效。 方法 根据纳入及排除标准,对127例供、受者临床资料进行回顾性分析,根据供者年龄分为高龄组(27例)和对照组(100例),对两组受者移植术后肝功能恢复情况、术后并发症发生情况及受者生存率进行分析。 结果 高龄组和对照组肝移植受者的移植物原发性无功能(PNF)和初期移植物功能不良(IPGF)发生率比较,差异均无统计学意义(均为P > 0.05)。术后2周内,高龄组肝移植受者丙氨酸转氨酶(ALT)平均水平、血清总胆红素(TB)与对照组比较,差异均无统计学意义(均为P > 0.05)。术后高龄组并发症发生情况与对照组相比,差异均无统计学意义(均为P > 0.05)。高龄组肝移植受者术后1、3年生存率分别为84%、78%,对照组分别为89%、79%,差异均无统计学意义(均为P > 0.05)。 结论 对高龄供肝应做好严格充分的质量评估和功能维护,术中精细操作、减少出血和创伤、缩短冷缺血和手术时间、加强术后监测和加速康复外科的实施,可取得良好的移植效果。 Abstract:Objective To explore the clinical efficacy of marginal liver from elderly donors in liver transplantation. Methods According to the inclusion and exclusion criteria, the clinical data of 127 donors and recipients were retrospectively analyzed. According to the age of donors, 127 donors were divided into the elderly group (n=27) and control group (n=100). The recovery of liver function, the occurrence of postoperative complications and survival rate of the recipients after transplantation were statistically analyzed between two groups. Results The incidence of primary nonfunction (PNF) and initial poor graft function (IPGF) did not significantly differ between the elderly and control groups (both P > 0.05). Within postoperative 2 weeks, the average levels of alanine aminotransferase (ALT) and serum total bilirubin (TB) of liver transplant recipients in the elderly group was not significantly different from those in the control group (both P > 0.05). There was no significant difference in the incidence of postoperative complications in the postoperative elderly group compared with the control group (all P > 0.05). The 1-and 3-year survival rates of the recipients in the elderly group were 84% and 78% respectively, which did not significantly differ from 89% and 79% in the control group (both P > 0.05). Conclusions Strict and sufficient quality evaluation and functional maintenance should be done for elderly donor livers. It can achieve good transplantation results by intraoperative fine operation, reducing bleeding and trauma, shortening the time of cold ischemia and operation, strengthening postoperative monitoring and implementing enhanced recovery after surgery. -
表 1 两组受者术后并发症发生情况比较
Table 1. Comparison of postoperative complications between the two groups [n(%)]
组别 n 排斥反应 胆道并发症 原发病复发 感染 高龄组 27 1(3) 6(22) 4(14) 0 对照组 100 1(1) 13(13) 15(15) 12(12) P值 0.381 0.276 0.437 0.186 -
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