原位肝移植后初期肝功能不良危险因素分析

Analysis of risk factors for initial poor graft function after orthotopic liver transplantation

目的 分析原位肝移植后导致初期肝功能不良 (IPGF)发生的危险因素。资料与方法 分析 36次原位肝移植。肝移植术后 72h内ALT和 (或 )AST >15 0 0IU/L作为IPGF组 ,<15 0 0IU/L作为非IPGF组。受体肝移植前分析指标为 :年龄、原发疾病、Child分级 ;供肝分析指标为 :热缺血时间、冷保存时间、冷保存末期肝活检 ;手术分析指标为 :受体手术时间、无肝期时间。结果 供肝热缺血时间IPGF组显著高于非IPGF组 (P =0 0 4 ) ,IPGF组受体肝功能ChildC者、供肝冷保存时间均高于非IPGF组 ,但未达到显著性差异 ,其余因素两组无差异 (P >0 0 5 )。结论 供肝热缺血时间是引起IPGF的危险因素 ,肝移植前肝功能ChildC级、供肝冷保存时间可能是潜在危险因素。

Objective To analyze the risk factors for initial poor graft function (IPGF) after orthotopic liver transplantation (OLT). Methods In an analysis of 36 OLT procedures, the group of IPGF was confirmed if ALT and/or AST were above (1 500) IU/L while non-IPGF below (1 500) IU/L within 72 h after OLT. Meanwhile, the recipient associated factors of age, primary liver diseases and Child's classification, the donor associated factors of war ischemic time, cold preservation time and liver biopsy at the end of cold ischemia and OLT associated factors of total operation time and anhepatic time were analyzed. Results The donor warm ischemic time was significantly longer in IPGF group than in non-IPGF group (P=0.04). There were no marked differences between the 2 groups in other factors in spite of higher values in Child C recipients' ratio and donor cold preservation time (P>0.05). Conclusions Longer donor warm ischemic time is an important risk factor for IPGF and Child C recipients' ration and longer donor cold preservation time are its potential risk factors.