中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2013年
6期
425-428
,共4页
甄作均%陈焕伟%吴志鹏%计勇%李梅生%陈应军%邓斐文%李杰原%王峰杰
甄作均%陳煥偉%吳誌鵬%計勇%李梅生%陳應軍%鄧斐文%李傑原%王峰傑
견작균%진환위%오지붕%계용%리매생%진응군%산비문%리걸원%왕봉걸
脑-心双死亡供体%肝移植%冷缺血时间%肝功能%并发症
腦-心雙死亡供體%肝移植%冷缺血時間%肝功能%併髮癥
뇌-심쌍사망공체%간이식%랭결혈시간%간공능%병발증
Donation after brain plus cardiac death%Liver transplantation%Cold ischemic time%Liver function%Complications
目的 探讨冷缺血时间(cold ischemic time,CIT)对脑-心双死亡(donation after brain plus cardiac death,DBCD)供肝肝移植术后早期肝功能的影响.方法 前瞻性地评估DBCD供肝肝移植术后1周肝功能的变化,通过与心脏死亡(donation after cardiac death,DCD)供肝肝移植比较,分析CIT与术后1周肝功能受损程度的相关性以及早期肝功能受损程度与术后早期并发症的相关性.结果 DBCD组CIT时间较DCD组明显缩短(4.6±1.8h比7.9±3.7h,P=0.002).DBCD组术后第1、3天ALT明显低于DCD组(535±227 IU/L比864±386 IU/L,P=0.026;254±94 IU/L比519±165 IU/L,P=0.003),相应的DBCD术后早期相关并发症发生率也明显低于DCD组(26.7％比57.1％,P=0.03).CIT时间长短与术后1周肝功能受损程度明显正相关(r2=0.914,P＜0.001),而术后早期肝功能的受损程度则与术后早期并发症的严重程度明显正相关(rs=0.791,P=0.002).结论 DBCD供肝肝移植具有较短的冷缺血时间,移植术后早期肝功能受损程度明显减轻,术后早期相关并发症也相应减少.DBCD是当前较为理想的供肝肝移植治疗模式.
目的 探討冷缺血時間(cold ischemic time,CIT)對腦-心雙死亡(donation after brain plus cardiac death,DBCD)供肝肝移植術後早期肝功能的影響.方法 前瞻性地評估DBCD供肝肝移植術後1週肝功能的變化,通過與心髒死亡(donation after cardiac death,DCD)供肝肝移植比較,分析CIT與術後1週肝功能受損程度的相關性以及早期肝功能受損程度與術後早期併髮癥的相關性.結果 DBCD組CIT時間較DCD組明顯縮短(4.6±1.8h比7.9±3.7h,P=0.002).DBCD組術後第1、3天ALT明顯低于DCD組(535±227 IU/L比864±386 IU/L,P=0.026;254±94 IU/L比519±165 IU/L,P=0.003),相應的DBCD術後早期相關併髮癥髮生率也明顯低于DCD組(26.7％比57.1％,P=0.03).CIT時間長短與術後1週肝功能受損程度明顯正相關(r2=0.914,P＜0.001),而術後早期肝功能的受損程度則與術後早期併髮癥的嚴重程度明顯正相關(rs=0.791,P=0.002).結論 DBCD供肝肝移植具有較短的冷缺血時間,移植術後早期肝功能受損程度明顯減輕,術後早期相關併髮癥也相應減少.DBCD是噹前較為理想的供肝肝移植治療模式.
목적 탐토랭결혈시간(cold ischemic time,CIT)대뇌-심쌍사망(donation after brain plus cardiac death,DBCD)공간간이식술후조기간공능적영향.방법 전첨성지평고DBCD공간간이식술후1주간공능적변화,통과여심장사망(donation after cardiac death,DCD)공간간이식비교,분석CIT여술후1주간공능수손정도적상관성이급조기간공능수손정도여술후조기병발증적상관성.결과 DBCD조CIT시간교DCD조명현축단(4.6±1.8h비7.9±3.7h,P=0.002).DBCD조술후제1、3천ALT명현저우DCD조(535±227 IU/L비864±386 IU/L,P=0.026;254±94 IU/L비519±165 IU/L,P=0.003),상응적DBCD술후조기상관병발증발생솔야명현저우DCD조(26.7％비57.1％,P=0.03).CIT시간장단여술후1주간공능수손정도명현정상관(r2=0.914,P＜0.001),이술후조기간공능적수손정도칙여술후조기병발증적엄중정도명현정상관(rs=0.791,P=0.002).결론 DBCD공간간이식구유교단적랭결혈시간,이식술후조기간공능수손정도명현감경,술후조기상관병발증야상응감소.DBCD시당전교위이상적공간간이식치료모식.
Objective To evaluate the impact of cold ischemic time (CIT) on early graft liver function after liver transplantation using cadaveric donors with brain plus cardiac death (DBCD).Methods The CIT and graft liver function were collected prospectively.The impact of CIT on early graft liver function after liver transplantation in DBCD was compared with donors with cardiac death (DCD).The relationship between early graft liver function and post-transplantation early complications were also studied.Results The CIT in the DCD group was significantly longer than the DBCD group (7.9±3.7 h vs.4.6±1.8 h,P=0.002).The levels of ALT in the DCD group on day 1 and 3 were higher than the DBCD group (864±386 IU/Lvs.535±227 IU/L,P=0.026; 519±165 IU/L vs.254±94 IU/L,P=0.003).Early complications after liver transplantation in the DCD group were also higher than the DBCD group (57.1％ vs.26.7％,P=0.03).The duration of CIT correlated with the degree of injury in early graft liver function after liver transplantation (r2 =0.914,P＜0.001).Obvious injury in early graft liver function resulted in serious early complications (rs =0.791,P=0.002).Conclusions These findings suggest that liver transplantation with DBCD was superior to DCD due to the shorter CIT and milder injury to early graft liver function.
