Portal vein reconstruction using vein grafts in pediatric living donor liver transplantation: Current status.
Portal vein reconstruction using vein grafts in pediatric living donor liver transplantation: Current status.
复制标题
在儿科活体肝移植中使用静脉移植物进行门静脉重建：现状。
DOI：
10.1111/petr.12888
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发表时间：
2017
影响因子：
1.3
通讯作者：
Uemoto S.
中科院分区：
文献类型：
--
作者：
Sabra TA;Okajima H;Yoshizawa A;Okamoto T;Anazawa T;Ygi S;Hata K;Yasuchika K;Taura K;Hatano E;Kaido T;Uemoto S.
门静脉重建是肝移植的一个重要方面，移植后的预后取决于门静脉重建的方法。然而，目前尚不清楚这些技术的优先选择是否取决于术前受者的特征。这项回顾性研究评估了接受和未接受VGS进行门静脉重建的儿科患者的术前受者因素是否不同。2010年1月至2015年7月，113例接受LDLT的儿科患者中，31例(27%)接受了VGS的门静脉重建，另外82例(73%)接受了VGS的重建。侧支血管(P<；.0001)和腹水(P=.02)的存在、门静脉大小(P<；.001)、血栓形成(P=.01)和血流方向(P=.01)、Child-Pugh A级与B/C肝功能(P=.01)、白蛋白浓度(P=.02)、主要诊断：BA与非BA(P=.03)以及是否接受过腹部手术(P<；.005)在接受和未接受VGS进行门静脉重建的患者中有显著差异。在1年的随访中，有无VGS的患者的PV并发症、患者存活率和移植物存活率没有显著差异。对于移植前PV发育不良、侧支循环强烈、肝血流不畅、肝脏状况不佳或有腹部手术经历的受者，应采集VGS。
PV reconstruction is an important aspect of LDLT, with post‐transplant outcomes depending on PV reconstruction methods. However, it is unclear whether the preferential selection of these techniques is dependent on preoperative recipient characteristics. This retrospective study assessed whether preoperative recipient factors differed in pediatric patients who did and did not receive VGs for PV reconstruction. Of 113 pediatric patients who underwent LDLT from January 2010 to July 2015, 31 (27%) underwent PV reconstruction with VGs and the other 82 (73%) without VGs. The presence of collateral vessels (P<.0001) and ascites (P=.02); PV size (P<.001), thrombosis (P=.01) and the direction of flow (P=.01), Child‐Pugh class A vs B/C liver function (P=.01), Alb concentration (P=.02), primary diagnosis: BA vs non‐BA (P=.03), and previous abdominal surgery (P<.005) differed significantly in patients who did and did not receive VGs for PV reconstruction. PV complications, patient survival, and graft survival did not differ significantly in patients with and without VGs at 1‐year follow‐up. VGs should be harvested for recipients with pretransplant hypoplastic PV, intense collaterals, hepatofugal flow, poor liver status, or previous abdominal surgery.