Single-Center Experience of Consecutive 522 Cases of Hepatic Artery Anastomosis in Living-Donor Liver Transplantation
Single-Center Experience of Consecutive 522 Cases of Hepatic Artery Anastomosis in Living-Donor Liver Transplantation
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DOI：
10.1016/j.transproceed.2015.06.014
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发表时间：
2015-07-01
影响因子：
0.9
通讯作者：
Lee, S. -K.
中科院分区：
文献类型：
--
作者：
Song, S.;Kwon, C. H. D.;Lee, S. -K.
Objective.本研究的目的是明确活体肝移植术后肝动脉并发症的危险因素和预后。从2004年到2010年，进行了522次连续LDLT。我们使用单变量和多变量分析，以确定危险因素的回顾性基础上，然后进行分析的成人病例。肝动脉并发症包括血栓形成、狭窄和假性动脉狭窄。动脉并发症发生率为4.79%（25例）。每例并发症为9例血栓形成、14例狭窄和2例假性动脉瘤。术前血红蛋白与血栓形成显著相关（P = 0.021），动脉大小与狭窄显著相关（P = 0.037）。我们没有发现动脉并发症和胆管狭窄之间的任何联系。然而，胆管狭窄治疗的结果与动脉狭窄相关。9例血栓形成患者中，7例患者接受了动脉化治疗，2例患者接受了低分子量肝素（LMWH）治疗。14例狭窄患者中，2例采用球囊扩张治疗，10例在低分子肝素下观察，2例再次移植。在假性动脉瘤的病例中，1例患者接受了动脉瘤翻修术，另1例患者接受了动脉瘤切除术。在我们的队列中，术前低血红蛋白水平是血栓形成的危险因素，动脉大小是狭窄的危险因素。
Objective. The aim of this study was to clarify risk factors and outcome of hepatic arterial complication after living-donor liver transplantations (LDLT).Methods. From 2004 to 2010, 522 consecutive LDLTs were performed. We used univariate and multivariate analysis to identify the risk factor on a retrospective basis, and then analysis was performed for adult cases. Hepatic arterial complication included thrombosis, stenosis, and pseudoaneurysm.Results. The arterial complication rate was 4.79% (25 cases). Each complication was 9 thromboses, 14 stenoses, and 2 pseudoaneurysms. Preoperative hemoglobin was significantly associated with thrombosis (P = .021), and arterial size with stenosis (P = .037). We could not find any association between arterial complications and biliary stricture. However, the outcome of biliary stricture treatment was associated with arterial stenosis. Of 9 cases with thrombosis, 7 patients underwent rearterialization and 2 were treated with lowmolecular-weight heparin (LMWH). Of 14 stenosis cases, 2 patients were treated with the use of balloon dilatation, 10 patients were observed under LMWH, and 2 patients underwent retransplantation. In cases of pseudoaneurysm, 1 patient underwent revision of the aneurysm and the other was observed.Conclusions. In our cohort, preoperative low hemoglobin level was a risk factor for thrombosis and artery size a risk factor for stenosis.