探讨脂肪肝供肝在肝脏移植中的价值

目的探讨应用不同脂肪沉着程度供肝对肝移植患者预后的影响。方法选取64例进行肝移植术患者,依据供肝浸润程度,随机分为轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组、无脂肪肝组共四组,每组各16例,比较四组患者肝功能(主要观察ALT、AST指标)、入住ICU的平均时间、1年移植物成活率、移植物原发无功发生率。结果轻度脂肪肝组入住ICU的平均时间、ALT和AST水平、移植物原发无功发生率与无脂肪肝组接近;中度脂肪肝组入住ICU平均时间、ALT和AST水平均较轻度组和无脂肪肝组明显增高,P0.05;重度脂肪肝组入住ICU平均时间、ALT和AST水平、移植物原发无功发生率明显较前三组为高,P0.05。结论轻、中度肝脏脂肪浸入可作为肝移植供肝,重度脂肪肝不能作为供肝的选择目标。

To Investigate the Value of Fatty Liver Donor Liver in Liver Transplatation

Objective To explore different degrees of donor fatty liver effects on recipient's prognosis. Methods We select 64 patients who have received liver transplantation surgery. according to the degree of fatty infiltration,they were randomly devided into 4 groups:mild fatty liver, moderate fatty liver, severe fatty liver,no tatty liver,and 16 patients in each group.The hepatic function including the serum levels of ALT and AST, the mean ICU duration after transplantation,1-year survival rate of the grafts after operation,the incidence of graft primary nonfunction were compared among the 4 groups. Results No significant defferences in the mean ICU duration after transplantation, the serum levels of ALT and AST,the grpft primary nonfunction were found between the no fatty liver group and the mild fatty liver group. The mean ICU duration after transplantation and the serum levels of ALT and AST were significantly higher in the moderate fatty liver geoup,P>0.05. However, the incidence of graft primary nonfunction was consistent among the three groups. The mean ICU dyration after transplantation, the serum levels of ALT and AST and the severe fatty liver group than in the first three groups(P<0.05). Conclusion The mild and moderate fatty liver can be used for liver transplantation. The severe fatty liver should not be selected as donor liver. Light, moderate fat liver as dipped into the living donor liver transplantation for liver, severe fatty liver can't as for donor liver choose target.