临床肝胆病杂志2017，Vol.33Issue(2)：316-319,4.DOI:10.3969/j.issn.1001-5256.2017.02.024
胆道闭锁患儿肝移植术后并发症分析
An analysis of postoperative complications in children with biliary atresia after liver transplantation
摘要
Abstract
Objective To investigate the postoperative complications and prognosis of children with biliary atresia treated with liver transplantation.Methods A retrospective analysis was performed for the clinical data of 41 children with biliary atresia who underwent primary liver transplantation in The Affiliated Children's Hospital of Chongqing Medical University from June 2006 to April 2014.Among these chil dren,28 underwent living donor liver transplantation (LDLT) and 13 underwent liver transplantation from donation after cardiac death (DCD) donors.The children undergoing LDLT or DCD liver transplantation were followed up for 67-90 months and 15-56 months,re spectively.The complications in the perioperative period and follow-up and prognosis were analyzed.The Fisher's exact test was used for comparison of categorical data between groups.Results Perioperative complications mainly included vascular complications,intra-abdom inal hemorrhage,intestinal perforation,rejection reaction,and infection.The incidence of hepatic artery thrombosis in DCD groups was significantly higher than LDLT groups (P =0.02).A total of 10 children died in the perioperative period,among whom 4 underwent LDLT (1 died of hepatic artery thrombosis,1 underwent DCD liver transplantation due to hepatic artery thrombosis and later died of primary graft failure,1 died of suffocation caused by vomiting,and 1 died of multiple organ failure) and 6 underwent DCD liver transplantation (1 child each died of hepatic artery thrombosis,pulmonary Klebsiella pneumoniae infection,septic shock after intestinal leakage,circulatory failure,severe capillary leak syndrome,and primary graft failure).During the follow-up,4 children undergoing LDLT died,among whom 2 died of hepatic vein stenosis,1 died of biliary tract infection,and 1 died of biliary stricture.No children undergoing DCD liver transplantation died or experienced complications during follow-up.Conclusion Various complications after liver transplantation in children with biliary atresia are important factors affecting the success rate of liver transplantation and long-term survival rates.Early prevention,early diagnosis,and timely treatment are very important to improve the prognosis of children undergoing liver transplantation.关键词
肝移植/胆道闭锁/手术后并发症/儿童Key words
liver transplantation/biliary atresia/postoperative complications/child分类
医药卫生引用本文复制引用
韩环立,张明满,郭春宝,康权,李英存,蒲从伦..胆道闭锁患儿肝移植术后并发症分析[J].临床肝胆病杂志,2017,33(2):316-319,4.基金项目
国家临床重点专科建设项目([2013]544) （[2013]544）
