青岛大学医学院学报2017，Vol.53Issue(3)：287-290,293,5.DOI:10.13361/j.qdyxy.201703010
公民逝世后器官捐献供肝移植术后早期肝功能不全的危险因素分析
RISK FACTORS FOR PRIMARY GRAFT DYSFUNCTION AFTER LIVER TRANSPLANTATION FROM DONATION AFTER CARDIAC DEATH
摘要
Abstract
Objective To investigate the incidence of primary graft dysfunction (PGD) after liver transplantation from donation after cardiac death (DCD) and the risk factors for PGD.Methods A retrospective study was performed for the clinical data of 42 donors and recipients who underwent liver transplantation in Center of Organ Transplantation in our hospital from July 2014 to March 2016.The donor data included sex,age,blood type,cause of death,length of intensive care unit (ICU) stay,degree of steatosis,cold ischemia time (CIT),warm ischemia time (WIT),and preoperative serum levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),and total bilirubin (TB),and the recipient data included sex,age,blood type,primary disease,preoperative Model for End-Stage Liver Disease (MELD) score,intraoperative blood loss,blood transfusion volume,duration of anhepatic phase,time of operation,and length of postoperative ICU stay.A univariate analysis was performed for these factors,and then a logistic regression analysis was performed for the factors with significant difference.Results The incidence rate of PGD after liver transplantation was 52.4％.The 1-,6-,and 12-month cumulative survival rates were 95.45％,86.36％,and 86.36％ in the PGD group and 95.00％,94.44％,and 94.44％ in the non-PGD group,and there were no significant differences between the two groups (P＞0.05).Length of ICU stay ≥72 h (OR=4.612,95％CI=1.283-16.579,P＜0.05) and CIT≥8 h (OR=6.097,95％CI=1.030-36.070,P＜0.05) in donors were independent risk factors for PGD.Conclusion Length of ICU stay ≥72 h and CIT ≥8 h in donors are independent risk factors for PGD.Therefore,shortening donor's CIT and length of ICU stay may help to reduce the incidence rate of PGD after liver transplantation.关键词
肝移植/公民逝世后器官捐献/肝功能不全/危险因素Key words
liver transplantation/donation after citizen's death/hepatic insufficiency/risk factors分类
临床医学引用本文复制引用
王婷婷,姜英俊,解曼,孔心涓,饶伟,臧运金..公民逝世后器官捐献供肝移植术后早期肝功能不全的危险因素分析[J].青岛大学医学院学报,2017,53(3):287-290,293,5.基金项目
青岛市自主创新重大专项(14-6-1-6-zdzx) （14-6-1-6-zdzx）
