儿童活体肝移植手术中供者体重指数及体脂率对受者术后早期肝功能恢复的影响

Effects of donor body mass index and body fat rate on the recovery of liver function after living donor liver transplantation in children

目的探讨在儿童活体肝移植手术中供者体重指数(body mass index,BMI)及体脂率(percentage body fat,PBF)对受者术后早期肝功能恢复的影响。方法采用回顾性研究方法,选取2019年12月—2021年4月首都医科大学附属北京友谊医院收治的接受活体肝移植手术患者32例,其中男性21例,女性11例,行活体肝移植手术平均月龄为(42.3±42.2)个月。通过32例受者术后2周内外周血ALT及天数,计算线性方程,得到斜率为降低趋势。分析其术后丙氨酸转氨酶(alanine aminotransferase,ALT)下降趋势。结果供者BMI正常组受者为19例,ALT下降趋势平均值为-89.41±80.18,供者BMI异常组受者为13例,ALT下降趋势平均值为-81.37±61.42,P=0.751,两组相比差异不具有统计学意义。供者体脂率肥胖组受者为6例,ALT下降趋势平均值为-71.23±5.93,供者体脂率非肥胖组受者为26例,ALT下降趋势平均值为-89.59±79.92,P=0.583,差异均没有统计学意义(P> 0.05)。结论儿童活体肝移植手术中供者体重指数及体脂率轻度异常,对受者术后早期肝功能恢复无明显影响,在临床供体选择上,我们可以选择BMI及体脂超过正常值的人群作为供者。

Objective To investigate the effects of donor body mass index(BMI) and percentage body fat(PBF) on early postoperative recovery of liver function in children undergoing living donor liver transplantation. Methods Thirty-two patients(21 males and 11 females) who received living liver transplantation in Beijing Friendship Affiliated to Capital Medical University from December 2019 to April 2021 were selected for a retrospective study. The mean age of recipients was(42.3±42.2) months. Postoperative alanine aminotransferase(ALT) downward trend was analyzed. Results There were 19 cases in the normal BMI group. The mean value of ALT downward trend was -89.41±80.18. There were 13 cases in the abnormal BMI group. The mean value of ALT downward trend was -81.37±61.42,P = 0.751. There were 26 cases in the non-obese group. The mean value of ALT downward trend was-89.59±79.92. There were 6 cases in the obese group. The mean value of ALT downward trend was-71.23±5.93,P = 0.583. There were no statistically significant differences(P > 0.05). Conclusion Mild abnormalities of donor BMI and BFR in pediatric living liver transplantation have no significant influence on the recovery of liver function in the early postoperative period. In clinical donor selection, we can select the donors whose BMI and PBF above normal values.