国际肝胆胰疾病杂志（英文版）
國際肝膽胰疾病雜誌（英文版）
국제간담이질병잡지（영문판）
Hepatobiliary & Pancreatic Diseases International
2013年
3期
256-262
,共7页
Model for End-stage Liver Disease%living donor liver transplantation%survival%right-lobe
BACKGROUND:?Controversy?exists?over?whether?living?donor?liver?transplantation?(LDLT)?should?be?offered?to?patients?with?high? Model? for? End-stage? Liver? Disease? (MELD)? scores.? This?study? tried? to? determine? whether? a? high? MELD? score? would?result?in?inferior?outcomes?of?right-lobe?LDLT. <br> METHODS:?Among? 411? consecutive? patients? who? received?right-lobe?LDLT?at?our?center,?143?were?included?in?this?study.?The? patients? were? divided? into? two? groups? according? to? their?MELD?scores:?a?high-score?group?(MELD?score?≥25;?n=75)?and?a?low-score?group?(MELD?score?<25;?n=68).?Their?demographic?data?and?perioperative?conditions?were?compared.?Univariable?and? multivariable? analyses? were? performed? to? identify? risk?factors?affecting?patient?survival. <br> RESULTS:?In? the? high-score? group,? more? patients? required?preoperative? intensive? care? unit? admission? (49.3%? vs? 2.9%;?P<0.001),? mechanical? ventilation? (21.3%? vs? 0%;? P<0.001),? or?hemodialysis?(13.3%?vs?0%;?P=0.005);?the?waiting?time?before?LDLT? was? shorter? (4? vs? 66? days;? P<0.001);? more? blood? was?transfused? during? operation? (7? vs? 2? units;? P<0.001);? patients?stayed?longer?in?the?intensive?care?unit?(6?vs?3?days;?P<0.001)?and? hospital? (21? vs? 15? days;? P=0.015)? after? transplantation;?more? patients? developed? early? postoperative? complications?(69.3%? vs? 50.0%;? P=0.018);? and? values? of? postoperative? peak?blood? parameters? were? higher.? However,? the? two? groups? had?comparable? hospital? mortality.? Graft? survival? and? patient?overall?survival?at?one?year?(94.7%?vs?95.6%;?95.9%?vs?96.9%),?three?years?(91.9%?vs?92.6%;?93.2%?vs?95.3%),?and?five?years?(90.2%?vs?90.2%;?93.2%?vs?95.3%)?were?also?similar?between?the?groups. <br> CONCLUSIONS:?Although? the? high-score? group? had? signifi-cantly?more?early?postoperative?complications,?the?two?groups?had? comparable? hospital? mortality? and? similar? satisfactory?rates? of? graft? survival? and? patient? overall? survival.? Therefore,?a?high?MELD?score?should?not?be?a?contraindication?to?right-lobe?LDLT?if?donor?risk?and?recipient?benefit?are?taken?into?full?account.
