Platelet Transfusion can be Related to Liver Regeneration After Living Donor Liver Transplantation
Platelet Transfusion can be Related to Liver Regeneration After Living Donor Liver Transplantation
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DOI：
10.1007/s00268-010-0464-x
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发表时间：
2010-05-01
影响因子：
2.6
通讯作者：
Suh, Kyung-Suk
中科院分区：
文献类型：
--
作者：
Kim, Joohyun;Yi, Nam-Joon;Suh, Kyung-Suk
虽然肝再生是活体肝移植（LDLT）的一个基本方面，但在移植后早期影响肝再生的因素尚未得到彻底研究。最近有人提出，血小板有助于肝再生。本研究的目的是确定在移植后早期影响肝移植物再生的主要因素，回顾性分析了87例右肝移植成人间LDLT患者。通过术后第9天和第11天之间获得的计算机断层扫描（CT）扫描的体积测定法评估肝再生。作者调查了临床变量与肝移植物再生率之间的关系，并对单变量分析发现的显著因素进行了多元回归分析。手术时平均移植物重量为722.9 +/- A 109.7 g，随访CT评估的平均移植物体积为1，042.2 +/- A 155.6 ml，反映平均肝移植物再生为45.9 +/- A 22.3%。移植物再生与移植物与受体重量比呈负相关（GRWR，r =-0.406，p < 0.001），与门静脉流速（cm/s; r = 0.307; p = 0.004）和脾指数（cm（3）; r = 0.282; p = 0.009）呈正相关。此外，输注的血小板总量（单位）与移植物再生显著相关（r = 0.293; p =-0.006）。逐步回归分析表明，（β = -33.124; p = 0.001），输注的血小板总量（β = 0.771; p = 0.012）和脾指数（beta = -0.010; p = 0.049）与移植物再生独立相关。本研究的结果表明，血小板在人类肝脏中起着重要作用LDLT后再生。
Although liver regeneration is a fundamental aspect of living donor liver transplantation (LDLT), the factors that affect liver regeneration during the early post-transplantation period have not been thoroughly investigated. Recently it was suggested that platelets contribute to liver regeneration. The aim of the present study was to identify the major factors that affect liver graft regeneration during the early post-transplantation period.Eighty-seven right liver grafted, adult-to-adult LDLT patients were retrospectively analyzed. Liver regeneration was assessed by volumetry from computed tomographic (CT) scans obtained between the 9th and 11th postoperative days. The authors investigated relationships between clinical variables and liver graft regeneration rates, and they conducted multiple regression analysis on factors found to be significant by univariate analysis.Mean graft weight at operation was 722.9 +/- A 109.7 g, and mean graft volume assessed by follow-up CT was 1,042.2 +/- A 155.6 ml, reflecting a mean liver graft regeneration of 45.9 +/- A 22.3%. The graft regeneration was found to correlate inversely with graft-to-recipient weight ratio (GRWR, r = -0.406, p < 0.001) and directly with portal flow velocity (cm/s; r = 0.307; p = 0.004) and splenic index (cm(3); r = 0.282; p = 0.009). Moreover, the total amount (units) of platelets transfused was found to be significantly associated with graft regeneration (r = 0.293; p = -.006). Stepwise regression analysis showed that GRWR (beta = -33.124; p = 0.001), total amount of platelets transfused (beta = 0.771; p = 0.012), and splenic index (beta = -0.010; p = 0.049) were independently associated with graft regeneration.The results of the present study suggest that platelets play a significant role in human liver regeneration after LDLT.