科研之友
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摘要
Background: Right lobar living donor living transplantation (LDLT) has been controversial because of widely differing reports of recipient morbidity. Herein, we present our nearly 10-year experience and identify factors that potentially could be modified to improve recipient outcome.
Material/Methods: The Clavien 5-tier grading system was applied retrospectively in 196 consecutive adult right lobar recipients. We determined the incidence of potentially life-threatening (Grade III), actually life-threatening (Grade IV), and lethal (Grade V) complications during the first post-transplant year. The most serious and seminal complication was considered if simultaneous or multiple complications appeared.
Results: One-year recipient/graft survival was 82%/82%. Within the first year, 68 (34.69%) of the 196 recipients had Grade III (n = 31), Grade IV (n = 7), or Grade V (n = 30) complications. The complications were 19.90% graft-related and 15.82% non-graft-related. Complications during the first half year did not decline with increased team experience over time and adversely affected recipients' long-term survival, albeit not significantly. According to univariate analysis, high Child-Pugh scores before transplantation (P = 0.016), prolonged ICU-stay (P = 0.003) and hospitalization time (P = 0.032) after transplantation were found to be risk factors for the appearance of >= Clavien III complications, while duct-to-duct biliary reconstruction (P = 0.02) had a beneficial role in reducing serious complications after LDLTs.
Conclusions: In conclusion, serious complications during the first post-transplant year shortened recipient survival and prolonged primary hospitalization duration and postoperative ICU-stay, which is more frequent in recipients with higher Child-Pugh scores and in those with hepaticojejunostomy.
- 出版日期2014-1-13
- 单位四川大学
