活体肝移植治疗胆道闭锁儿童临床疗效研究

doi:10.3969/j.issn.1672-5069.2021.03.032

Abstract

Abstract: Objective The aim of this study was to investigate the clinical efficacy of living donor liver transplantation (LDLT) for treatment of Children with biliary atresia (BA).Methods 74 children with BA were recruited in our hospital between September 2010 and October 2016, and 36 children underwent LDLT, and 38 children received LDLT after Kasai failure. All the children were followed-up for 36 months. The Kaplan-Meier survival analysis was applied to compare the cumulative survival rate between the two groups.Results The median age in children receiving LDLT after Kasai was 12.5(5.8, 72.5) months, significantly older than 7.2(5.8, 36.8) months (P<0.05) in children receiving LDLT directly, the weight was (12.8 5.2) kg, significantly higher than (10.2±6.6) kg (P<0.05) in children receiving LDLT directly, the preoperative serum bilirubin level was 158.4 (20.4,500.8) μ mol/l, significantly lower than 250.9 (60.8,468.0) μ mol/l (P<0.05) in children receiving LDLT directly, the pediatric end-stage liver disease (PELD) score was (12.5±9.6), significantly lower than [(20.8 15.4), P<0.05] in children receiving LDLT directly, while there were no significant differences in graft quality, donor liver weight to recipient weight ratio (GRWR), hot ischemia time, cold ischemia time, intraoperative blood loss and intraoperative blood transfusion between the two groups ((P>0.05); the incidence of post-operative complications in children receiving LDLT was 55.6%(20/36), significantly lower than [68.4%(26/38), P<0.05] in children underwent LDLT after Kasai; the 1-month, 1-year and 3-year cumulative survival rates in children receiving LDLT after Kasai were 97.3%, 94.7% and 89.5%, not significant different as compared to 97.2%, 91.7% and 86.1% in children receiving LDLT directly (P>0.05).Conclusion We recommend based on our results that the LDLT should be directly given in children with BA, which might obtain a better outcomes in future.

Key words: Biliary atresia, Living donor liver transplantation, Kasai operation, Kaplan-Meier survival analysis

Chang Qingfeng, Wang Jing, Song Cuiping. Clinical efficacy of living donor liver transplantation for treatment of Children with biliary atresia[J]. Journal of Practical Hepatology, 2021, 24(3): 431-434.

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Clinical efficacy of living donor liver transplantation for treatment of Children with biliary atresia

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