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心脏死亡者供肝移植术后受体早期肝功能恢复不良的影响因素分析
引用本文:杨洋,矫宁,陈新国,韩艳萍,李自强,张庆. 心脏死亡者供肝移植术后受体早期肝功能恢复不良的影响因素分析[J]. 武警医学, 2021, 32(9): 790-794
作者姓名:杨洋  矫宁  陈新国  韩艳萍  李自强  张庆
作者单位:1.100039 北京,解放军总医院第三医学中心器官移植科;2.261053,潍坊医学院;3.101149 北京,解放军总医院京东医疗区
基金项目:国家重大科学研究计划A类项目(973计划)(2014CBA02001)
摘    要:目的 探讨"中国二类"(DCD)和"中国三类"(DBCD)心脏死亡器官捐献(统称为DCD)的供体和受体因素对肝移植术后早期肝功能恢复不良的影响.方法 回顾性分析2013-09至2017-01在解放军总医院第三医学中心实施的211例DCD肝移植的临床资料,主要包括供体和受体的性别、年龄、原发病、血型、体质量指数(BMI)...

关 键 词:肝移植  心脏死亡器官捐献  供体  受体  肝功能不全
收稿时间:2021-04-19

Analysis of influencing factors of early poor recovery of liver function after liver transplantation with organ donation for cardiac death
YANG Yang,JIAO Ning,CHEN Xinguo,HAN Yanping,LI Ziqiang,ZHANG Qing. Analysis of influencing factors of early poor recovery of liver function after liver transplantation with organ donation for cardiac death[J]. Medical Journal of the Chinese People's Armed Police Forces, 2021, 32(9): 790-794
Authors:YANG Yang  JIAO Ning  CHEN Xinguo  HAN Yanping  LI Ziqiang  ZHANG Qing
Affiliation:1. Department of Organ Transplantation, Third Medical Center, General Hospital of Chinese PLA, Beijing 100039, China;2. Weifang Medical University,Weifang 261035,China;3. Eastern Medical District of Chinese PLA General Hospital. Beijing 101149, China
Abstract:Objective To assessment the risk factors on poor early liver function recovery. of recipient after liver transplantation (LT) using allografts from donation after cardiac death (DCD) or brain and cardiac death(DBCD)donors.Methods In this retrospectively study, 211 liver transplantation using grafts from DCD or DBCD donors were performed at the Third Medical Center, General Hospital of Chinese PLA from September 2013 to January 2017. We collected data of recipient and donor including gender, age, primary disease, ABO blood type, body mass index (BMI), medical history (fatty liver, hypertension), ICU hospitalization time, mechanical ventilation time, warm ischemia time, cold ischemia time, intraoperative blood loss, operation time, Model for End-Stage Liver Disease (MELD) score and indexes of routine laboratory test, et al. Statistical analysis using the chi-square test, multivariate step-wise Cox regression were performed.Results Of the 211 patients, intraoperative blood loss (P=0.046), BMI (P=0.035), MELD score (P=0.000), and donor age (P=0.047), male gender (P=0.028), serum potassium level (P=0.001), extubation to cardiac arrest (P=0.004), as well as donor ICU hospitalization time (P=0.022) all related to the early liver dysfunction after LT. Multivariate step-wise Cox regression showed that the intraoperative blood loss(P=0.001,HR=12.512,95%CI: 2.679-58.434), MELD score(P=0.021,HR=3.991,95%CI: 1.237-12.876)were independent prognostic risk factors.Conclusions Controlling intraoperative blood loss and selecting receptors with MELD score <25 may further improve the early liver function and prognosis of recipients after LT.
Keywords:liver transplantation  donors after cardiac death  donors  recipients  hepatic insufficiency  
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