心脏死亡器官捐献供者应用血管活性药物对供肝质量及肝移植受者的影响

The impact of vasoactive drugs on liver transplant recipients and allografts in donors after cardiac death

目的探讨心脏死亡器官捐献（DCD）供者维护中的血管活性药物应用对肝移植受者及移植物的影响。方法回顾分析2011年7月至2012年7月问19例DCD供肝移植的临床资料，依据DCD供者在器官切取前是否使用血管活性药物维持血压，将19例DCD供肝移植的供、受者分为血管活性药物组（用药组）和未使用血管活性药物组（未用药组）。观察和比较两组供、受者间的临床特征、术后并发症、受者和移植物存活时间等。结果术后两组受者间肝功能指标均无显著差异。两组受者均未出现与供者相关的胆道并发症、原发性移植物功能不全、门静脉狭窄、肝动脉血栓形成等。用药组受者及移植物的存活时间为（4．2±4．2）个月，未用药组为（6．2±4．2）个月，两组受者及移植物的存活时间基本相同（P〉0．05）。结论在DCD供者的维护中，血管活性药物的应用对肝移植后移植肝功能、胆道并发症、原发性移植物功能不全、门静脉狭窄、肝动脉血栓形成及受者和移植物的存活时间并无明显影响。

Objective To define the impact of vosoactive drugs on liver transplant recipients and allografts in donors after cardiac death （DCD）. Method From July 2011 through July 2012,19 liver transplantations were performed from DCD. Donor and recipient characteristics, posttransplant complications, and patient and allograft survival time in both groups with or without use of vasoactive drugs were compared. Results No differences in liver functions （ALT,AST,GGT,TB,INR） ,primary graft disfunction, hepatic artery thrombosis, portal vein stenosis, or biliary complications were noted between two groups. The survival time in vasoactive drugs group was 4. 2±4. 2 months and that in non-vasoactive drugs group was 6. 2±4. 2 months, respectively （ P〉0. 05）. Conclusion The application of vasoactive drugs has no influence on liver function, primary graft disfunction, hepatic artery thrombosis, portal vein stenosis, biliary complications and survival time in DCD in comparison with DCD not given vasoactive drugs.