实用肝脏病杂志 ›› 2023, Vol. 26 ›› Issue (5): 738-741.doi: 10.3969/j.issn.1672-5069.2023.05.034

• 肝移植 • 上一篇    下一篇

Clavien-Dindo分级系统分析不同供肝类型肝移植患者术后早期并发症发生率比较研究*

张树庚, 张少博, 朱泽斌, 栗雪峰, 蔡伟, 郭亚飞, 刘连新   

  1. 230036 合肥市 中国科学技术大学附属第一医院/安徽省立医院肝胆外科器官移植中心
  • 收稿日期:2023-06-06 出版日期:2023-09-10 发布日期:2023-09-13
  • 通讯作者: 郭亚飞,E-mail:guoyafei_2008@163.com
  • 作者简介:张树庚,男,39岁,医学博士,副主任医师。E-mail:shugeng517@163.com
  • 基金资助:
    *安徽省自然科学基金资助项目(编号:2208085MH245)

Early post-operational complications in patients with orthotopic liver transplantation receiving different deceased donors

Zhang Shugeng, Zhang Shaobo, Zhu Zebin, et al   

  1. Centre of Hepatobiliary Surgery and Organ Transplantation, Anhui Provincial Hospital, First Affiliated Hospital, University of Science and Technology of China, HeFei 230036, Anhui Province, China
  • Received:2023-06-06 Online:2023-09-10 Published:2023-09-13

摘要: 目的 采用Clavien-Dindo分级系统分析接受不同供肝的原位肝移植受者发生早期并发症的差异。 方法 2017年4月~2020年12月我中心诊治的60例终末期肝病患者,均接受公民逝世后器官捐献肝移植术治疗,其中接受脑死亡后捐献(DBD)27例,接受心脏死亡后捐献(DCD)26例和接受脑-心双死亡后捐献(DBCD)7例,均接受同种异体经典原位肝移植术。采用Clavien-Dindo分级系统对术后早期(1个月内)并发症进行分级,比较Ⅲ级及以上并发症发生率。 结果 在60例患者中,有16例(26.6%)发生了术后早期III级及以上的并发症,其中DBD组2例 (7.4%),DCD组2例 (7.7%),DBCD组2例 (28.6%);DBD组发生IV级并发症 1例 (3.7%),DCD组2例 (7.7%),DBCD组无(0.0%); DBD组发生V级并发症(死亡)3例 (11.1%),DCD组3例 (11.5%),DBCD组1例 (14.3%),三组并发症发生率比较,无显著性差异(P>0.05)。 结论 与标准的DBD供肝移植比,接受DCD或DBCD供肝移植也不增加术后早期并发症的发生。

关键词: 原位肝移植, 终末期肝病, 手术并发症, 死亡捐献, Clavien-Dindo分级, 治疗

Abstract: Objective The aim of this study was to investigate the incidences of early post-operational complications in patients with orthotopic liver transplantation (OLT) receiving different deceased donors. Methods 60 patients with end-stage liver diseases were encountered in our center between April 2017 to December 2020, and all underwent allogeneic classical OLT, receiving donation after brain death (BDB) in 27 cases, donation after cardiac death (DCD) in 26 cases and donation after brain death followed by cardiac death (DBCD) in 7 cases. The early (less than 1 month) postoperative complications was defined according to Clavien-Dindo classification, and the incidences of grade III and the above complications were compared among the three groups. Results Out of the 60 patients after OLT, the early postoperative complications of grade III or above occurred in 16 cases (26.6%), and in the grade III complications, there were 2 cases (7.4%) in DBD group, 2 cases (7.7%) in DCD group and 2 cases (28.6%) in DBCD group; as for the grade IV complications, there were 1 case (3.7%) in DBD group, 2 cases (7.7%) in DCD group, and no cases (0.0%) in DBCD group; in the grade V (death) complications, there were 3 cases (11.1%) in DBD group, 3 cases (11.5%) in DCD group, and 1 case (14.3%) in DBCD group, no significant differences as respect to the incidences of complications among the three groups (P>0.05). Conclusion Compared with the standard DBD donor liver, the patients receiving liver from DCD donor or from DBCD donor do not increase the incidence of early postoperative complications.

Key words: Orthotopic liver transplantation, End-stage liver disease, Surgical complications, Deceased donors, Clavien-Dindo classification, Therapy