CAJ | 학술논문

目的：探讨婴幼儿活体肝移植受者接受乙肝核心抗体阳性（HBcAb+）供肝后术后早期安全性分析。方法对天津市第一中心医院自2010年7月至2013年12月86例活体婴幼儿肝移植供受体的资料进行收集和登记，依据供肝HBcAb检测结果分为HBcAb+组32例和HBcAb-组54例，对两组患儿术前状态、手术时间、重症监护病房（ICU）逗留时间、术后肝功能指标进行比较分析。结果86例亲体肝移植受者死亡5例，总病死率为5.81%，HBcAb+组和HBcAb-组病死率分别为9.37%和3.70%，两组病死率比较差异无统计学意义。所有患儿在围术期均无新发乙肝出现；两组受者平均年龄、平均体重、术前PELD评分，两组供者平均年龄、平均体重、供肝重量，受者手术时间（分钟：547.44±71.93比546.76±95.67）、ICU逗留时间（小时：119.27±50.61比126.61±70.78）、术前1、2天及术后1、3、7、14、28天血清总胆红素（TBil）、直接胆红素（DBil）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、国际标准化比值（INR）比较差异均无统计学意义（均P＞0.05）。结论在精准评估及采取适当措施预防乙肝复发的基础上，HBcAb+供肝至少在围术期对患儿是安全的。
목적：탐토영유인활체간이식수자접수을간핵심항체양성（HBcAb+）공간후술후조기안전성분석。방법대천진시제일중심의원자2010년7월지2013년12월86례활체영유인간이식공수체적자료진행수집화등기，의거공간HBcAb검측결과분위HBcAb+조32례화HBcAb-조54례，대량조환인술전상태、수술시간、중증감호병방（ICU）두류시간、술후간공능지표진행비교분석。결과86례친체간이식수자사망5례，총병사솔위5.81%，HBcAb+조화HBcAb-조병사솔분별위9.37%화3.70%，량조병사솔비교차이무통계학의의。소유환인재위술기균무신발을간출현；량조수자평균년령、평균체중、술전PELD평분，량조공자평균년령、평균체중、공간중량，수자수술시간（분종：547.44±71.93비546.76±95.67）、ICU두류시간（소시：119.27±50.61비126.61±70.78）、술전1、2천급술후1、3、7、14、28천혈청총담홍소（TBil）、직접담홍소（DBil）、병안산전안매（ALT）、천동안산전안매（AST）、국제표준화비치（INR）비교차이균무통계학의의（균P＞0.05）。결론재정준평고급채취괄당조시예방을간복발적기출상，HBcAb+공간지소재위술기대환인시안전적。
Objective To evaluate the early safety of HBcAb positive donor used on pediatric living donor liver transplant recipients.Methods We collected and registered the data of86 pediatric living donor liver transplant recipients from July2010 to December2013 in Tianjin First Center Hospital. The patients were divided into HBcAb+ group and HBcAb- group according to donors' serum test of HBcAb. The preoperative state, operation time, ICU stay time and postoperative liver function of both group were compared.Results5 cases died among86 pediatric living donor liver transplant recipients,and total mortality was5.81% with9.37% and3.70% for HBcAb+ group and HBcAb- group respectively without statistical difference. All pediatric recipients had no hepatitis B occurred perioperatively and there were no statistical differences of two groups in average age and weight of recipients, preoperative PELD scores, average age and weight of donors,weight of liver graft, operation time(547.44±71.93 min vs.546.76±95.67 min), ICU stay(119.27±50.61 hr vs.126.61±70.78 hr), serum value of total bilirubin,direct bilirubin,glutamic-pyruvic transaminase,glutamic-oxalacetic transaminase and international normalized ratio of1 and2 days before operation and post-operative day1,3,7,14,28. (P>0.05).Conclusion HBcAb positive liver grafts, on the basis of accurate assessment and appropriate measurement applied to prevent hepatitis B recurrence, were safe for pediatric patients perioperatively at least.