CAJ | 학술논문

目的探讨不同扩大标准的供体肝脏在成人肝脏移植中的应用经验.方法我院自2003年1月至2009年6月共施行肝脏移植126例,其中接受标准供体肝移植74例,接受了扩大标准供体52例.根据所含风险因素的不同,将扩大标准的供体分为E1组(含1～2个风险因素)35例、E2组(含3个以上风险因素)17例.与接受标准供体的74例患者相比较,分析52例接受扩大标准供体的受体的临床资料及生存情况.结果同标准供体组相比较接受扩大标准供体组受体术后半年和1年生存率差异无统计学意义(分别x2=2.55,3.64,均P＞0.05).但接受标准供体组受体2年生存率优于接受扩大标准供体组受体(x2 =4.9,P＜0.05).同标准供体组相比,接受E1组扩大标准供体组受体术后半年、1年和2年生存率差异无统计学意义(分别x2=0.85,0.45,0.23,均P＞0.05).E2组受体术后半年、1年和2年生存率均低于接受标准供体肝脏的受体(分别x2=3.91,8.67,11.34,均P＜0.05).MELD评分＜20的患者接受E2组供体术后半年、1年和2年生存率与MELD评分＞20的患者接受E1组供体,差异有统计学意义(分别x2=0.16,0.16,0.07,均P＜0.05).供肝冷缺血时间＞12h是影响受体生存率的独立危险因素.结论在所含风险因素较少的情况下,扩大标准的供体肝脏或者MELD评分＜20的受体是可以应用的.
목적 탐토불동확대표준적공체간장재성인간장이식중적응용경험.방법 아원자2003년1월지2009년6월공시행간장이식126례,기중접수표준공체간이식74례,접수료확대표준공체52례.근거소함풍험인소적불동,장확대표준적공체분위E1조(함1～2개풍험인소)35례、E2조(함3개이상풍험인소)17례.여접수표준공체적74례환자상비교,분석52례접수확대표준공체적수체적림상자료급생존정황.결과 동표준공체조상비교접수확대표준공체조수체술후반년화1년생존솔차이무통계학의의(분별x2=2.55,3.64,균P＞0.05).단접수표준공체조수체2년생존솔우우접수확대표준공체조수체(x2 =4.9,P＜0.05).동표준공체조상비,접수E1조확대표준공체조수체술후반년、1년화2년생존솔차이무통계학의의(분별x2=0.85,0.45,0.23,균P＞0.05).E2조수체술후반년、1년화2년생존솔균저우접수표준공체간장적수체(분별x2=3.91,8.67,11.34,균P＜0.05).MELD평분＜20적환자접수E2조공체술후반년、1년화2년생존솔여MELD평분＞20적환자접수E1조공체,차이유통계학의의(분별x2=0.16,0.16,0.07,균P＜0.05).공간랭결혈시간＞12h시영향수체생존솔적독립위험인소.결론 재소함풍험인소교소적정황하,확대표준적공체간장혹자MELD평분＜20적수체시가이응용적.
Objective To evaluate extended criteria donor liver in adult cadaveric liver transplant.Methods 126 liver transplantations were performed from January 2003 to June 2009,of them,74 patients received standard criteria donor livers,52 patients received extended criteria donor livers.These 52 donor livers could be divided into two groups:E1 group (a graft with 1 to 2 risk factors) and E2 group(a graft with 3 to 4 risk factors).Results There was no significant difference in half a year and 1 year survival rates between patients received E1 group extended criteria donor livers and those received standard criteria donor livers(respectively x2 =2.55,3.64,all P ＞0.05).But 2 year survival rate of patients received E1 group extended criteria donor livers was lower than those receiving standard criteria donor livers (x2 =4.9,P ＜0.05).Half a year,1 year and 2 year survival rates in patients receiving E2 group extended criteria donor livers were less than those receiving standard criteria donor livers (respectively x2 =3.91,8.67,11.34,all P ＜ 0.05).The half a year,1 year,and 2 year survival rates of patients received extended criteria donor livers with MELD score more than 20 was less than those with MELD score ＜ 20 (respectively x2 =0.16,0.16,0.07,all P ＜ 0.05).Conclusions Extended criteria donor livers can be used safely if the risk factor of donor liver was less than 3,or when recipient's MELD score was ＜20.