移植物与受体质量比对婴儿活体肝移植术后门静脉流速的影响

Influence of graft-to-body weight ratio on portal blood flow velocity in recipients after adult-to-infant living donor liver transplantation

目的 通过多普勒超声技术对婴儿活体肝移植术后早期没有严重并发症的受体门静脉流速进行测量,确定其术后早期门静脉流速的范围,并分析探讨影响门静脉流速的因素.方法 回顾分析于2008年4月至2009年12月间实施成功的成人活体供肝婴儿肝移植患儿22例（男14例,女8例,平均年龄为（6.8±2.5）个月,范围为80d至12个月.在术后第一个三天内,运用彩色多普勒超声仪检测受体术后门静脉流速及门静脉管径.通过Pearson＇s相关性检验分析受体年龄、受体门静脉管径、受体体重、移植物质量、移植物与受体质量比和受体术后门静脉流速的相关性.以多元回归分析确定独立因素与受体门静脉流速的关联性.结果 术后第一个三天受体门静脉流速的平均值是（36±15）cm/s（范围为17～73 cm/s）.统计分析发现移植物与受体质量比和受体术后门静脉流速存在负相关（r=-0.591,P=0.005）.多元回归分析显示移植物与受体质量比独立地与受体门静脉流速呈负相关（β=-10.483,P=0.005）.结论 婴儿活体肝移植术后早期,移植物与受体质量比值影响着受体术后门静脉流速,并且受体门静脉血流速在术后早期有一宽量程.

Objective To determine the range of portal blood flow velocity with Doppler sonography in recipients without major complications after adult-to-infant living donor liver transplantation （A-ILDLT） and to explore factors affecting portal blood flow velocity. Methods Twenty-two patients （14 males and 8 females with the mean age of 6. 8 months ± 2. 5 months） who underwent adult-to-infant living donor liver transplantation were enrolled. The diameter and peak portal blood flow velocity of the recipient portal vein were measured with Doppler sonography within the first three postoperative days. Utilizing Pearson＇s test, the correlations between the age of recipients, diameter of portal vein,the body weight of host, the graft weight, the graft-to-body weight ratio and recipient portal blood flow velocity were analyzed. Multiple regression analysis was performed to determine the correlation between independent factors and recipient portal blood flow velocity. Results The mean peak portal blood flow velocity was （36 ± 15） cm/s ranging from 17 cm/s to 73 cm/s. There was significantly negative correlation （r = - 0. 591, P = 0. 005 ） between Portal blood flow velocity and graft-to-body weight ratio. Multiple regression analysis showed graft-to-body weight ratio independently correlated with portal blood flow velocity （β= - 10. 483, P = 0. 005）. Conclusions Depending on the graft-tobody weight ratio, recipient portal blood flow velocity has a wide range within the early days after adult-to-infant living donor liver transplantation.