Complications of living donor hepatic lobectomy--a comprehensive report.
Complications of living donor hepatic lobectomy--a comprehensive report.
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活体供体肝叶切除术的并发症 - 一份全面的报告。
DOI：
10.1111/j.1600-6143.2011.03972.x
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发表时间：
2012-05
期刊：
影响因子：
--
通讯作者：
A2ALL Study Group
中科院分区：
文献类型：
--
作者：
Abecassis MM;Fisher RA;Olthoff KM;Freise CE;Rodrigo DR;Samstein B;Kam I;Merion RM;A2ALL Study Group
活体肝移植的广泛应用受到供体发病率问题的限制。一项由760名接受手术的活体供者组成的观察性队列，并参加了成人间活体供者肝移植队列研究，对活体供肝（LLD）并发症的发生率、严重程度和自然史进行了全面评估。供体发病率（评估29个特定的并发症），预测因素，从捐赠到并发症的时间和从并发症发作到解决的时间是12年期间的测量结果。在760例供体手术中，20例流产，740例完成。40%的供体有并发症（296名供体中有557例并发症），主要是Clavien 1级和2级。按并发症类别计算的最严重程度; 1级（轻微，n = 232）; 2级（可能危及生命，n = 269）; 3级（残留残疾，n = 5）和4级（导致死亡，n = 3）。疝（7%）和心理并发症（3%）发生在捐赠后>1年。并发症风险随着输血要求、术中低血压和献血前血清胆红素的增加而增加，但并不随着中心LLD经验的增加而降低。1年内并发症解决的概率总体为95%，但疝仅为75%，心理并发症为42%。该报告全面量化了LLD并发症风险，并应告知潜在捐赠者及其护理人员的决策。
A wider application of living donor liver transplantation is limited by donor morbidity concerns. An observational cohort of 760 living donors accepted for surgery and enrolled in the Adult-to-Adult Living Donor Liver Transplantation cohort study provides a comprehensive assessment of incidence, severity and natural history of living liver donation (LLD) complications. Donor morbidity (assessed by 29 specific complications), predictors, time from donation to complications and time from complication onset to resolution were measured outcomes over a 12-year period. Out of the 760 donor procedures, 20 were aborted and 740 were completed. Forty percent of donors had complications (557 complications among 296 donors), mostly Clavien grades 1 and 2. Most severe counted by complication category; grade 1 (minor, n = 232); grade 2 (possibly life-threatening, n = 269); grade 3 (residual disability, n = 5) and grade 4 (leading to death, n = 3). Hernias (7%) and psychological complications (3%) occurred >1 year postdonation. Complications risk increased with transfusion requirement, intraoperative hypotension and predonation serum bilirubin, but did not decline with the increased center experience with LLD. The probability of complication resolution within 1 year was overall 95%, but only 75% for hernias and 42% for psychological complications. This report comprehensively quantifies LLD complication risk and should inform decision making by potential donors and their caregivers.
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影响因子：
8.8
作者：
Adcock, L.;Macleod, C.;Therapondos, G.
通讯作者：
Therapondos, G.
影响因子：
9
作者：
CLAVIEN, PA;SANABRIA, JR;STRASBERG, SM
通讯作者：
STRASBERG, SM
影响因子：
6.2
作者：
Iida, Taku;Ogura, Yasuhiro;Uemoto, Shinji
通讯作者：
Uemoto, Shinji
影响因子：
6.2
作者：
Trotter, James F.;Hill-Callahan, Margaret M.;Weinrieb, Robert M.
通讯作者：
Weinrieb, Robert M.
影响因子：
25.7
作者：
Marsh, James W.;Gray, Edward;Starzl, Thomas E.
通讯作者：
Starzl, Thomas E.