Timing of hepatic artery reperfusion and biliary strictures in liver transplantation.
Timing of hepatic artery reperfusion and biliary strictures in liver transplantation.
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DOI：
10.1155/2013/757389
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发表时间：
2013
影响因子：
2.5
通讯作者：
Wolf DC
中科院分区：
文献类型：
--
作者：
Gunasekaran G;Sharma J;Mosna LC;Bodin R;Wolf DC
在原位肝移植（奥尔特）过程中，胆道灌注与肝动脉再灌注（HARP）一起发生，通常在门静脉再灌注（PVRP）后进行。我们研究了PVRP和HARP之间的平均时间间隔是否影响术后胆管狭窄的发生。2007年至2009年接受奥尔特的患者如果年龄≥18岁，术后存活3个月，并且有PVRP和HARP数据，则纳入。排除接受DCD供体同种异体移植的患者。术后随访6个月。75例患者符合研究入选标准。其中，10例患者有胆管狭窄。在年龄、性别、病因、MELD评分、移植物存活率和PVRP与HARP之间的时间间隔方面，有和无胆管狭窄的患者之间没有统计学差异。90%的胆管狭窄患者的PVRP-HARP时间间期>30分钟，而无胆管狭窄患者的PVRP-HARP时间间期>30分钟的比例为77%。然而，这在统计学上并不显著。两组冷缺血时间差异有统计学意义。PVRP后HARP的时间间隔似乎不会影响胆管狭窄的发展。然而，30分钟可能被认为是一个关键时间，在此之后，胆管狭窄的发生率增加。
During orthotopic liver transplantation (OLT), biliary tract perfusion occurs with hepatic artery reperfusion (HARP), commonly performed after the portal vein reperfusion (PVRP). We examined whether the average time interval between PVRP and HARP impacted on postoperative biliary strictures occurrence. Patients undergoing OLT from 2007 to 2009 were included if they were ≥18 years old, had survived 3 months postoperatively, and had data for PVRP and HARP. Patients receiving allografts from DCD donors were excluded. Patients were followed for 6 months post-OLT. Seventy-five patients met the study inclusion criteria. Of these, 10 patients had a biliary stricture. There was no statistical difference between those with and without biliary stricture in age, gender, etiology, MELD score, graft survival, and time interval between PVRP and HARP. Ninety percent of patients with biliary stricture had a PVRP-HARP time interval >30 minutes, as opposed to 77% of patients without biliary stricture. However, this was not statistically significant. The cold ischemia time was significantly different between the two groups. Time interval for HARP after PVRP did not appear to affect the development of biliary strictures. However, 30 minutes may be suggested as a critical time after which there is an increase in biliary stricture occurrence.