肝移植术中入肝血流量对术后早期移植物功能不全的临床意义

Clinical Significance of Intraoperative Blood Flow into the Transplanted Liver in Early Allograft Dysfunction after Liver Transplantation

目的探讨肝移植术中入肝血流量对术后早期移植物功能不全(EAD)发生的临床意义。方法回顾性分析2006年1月至2016年10月我科室治疗的138例肝移植受体的临床资料。根据EAD的诊断标准分为2组:发生EAD组(EAD组)和未发生EAD组(非EAD组)。比较2组患者入肝血流量与各高危因素的关系,并采用logistic多因素分析确定术后发生EAD的危险因素。结果与非EAD组比较,EAD组术中门静脉最大血流量差异具有统计学意义(P <0.05)。经logistic多因素分析发现,术中门静脉最大血流量<1 600 mL/min是术后EAD的独立危险因素。结论肝移植术中门静脉最大血流量<1 600 mL/min是术后EAD的独立危险因素,检测肝移植术中入肝血流量可为术后是否发生EAD提供参考。

Objective To determine the risk factors associated with early allograft dysfunction( EAD) after liver transplantation. Methods We retrospectively analyzed the records of 138 patients who underwent liver transplantation from January 2006 to October 2016 in our department. Transplant recipients were divided into two groups:those who met the diagnostic criteria of EAD( EAD group) and those who did not( non-EAD group). We compared blood flow into the transplanted livers and other clinical features between the two groups using univariate and multivariate analysis. Results Intraoperative portal vein flow( PVF) maximum was significantly different between the two groups. Multivariate analysis revealed that intraoperative PVF maximum <1 600 mL/min was the only independent risk factor for the occurrence of EAD after liver transplantation in this cohort. Conclusion Intraoperative PVF maximum <1 600 mL/min is an independent risk factor for the occurrence of EAD after liver transplantation. Measuring intraoperative blood flow into the transplanted liver in liver transplant recipients may help identify patients at risk for developing EAD.