The Incidence of Posthepatectomy Liver Failure Defined by the International Study Group of Liver Surgery among Living Donors
The Incidence of Posthepatectomy Liver Failure Defined by the International Study Group of Liver Surgery among Living Donors
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DOI：
10.1007/s11605-016-3080-8
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发表时间：
2016-04-01
影响因子：
3.2
通讯作者：
Ku, Yonson
中科院分区：
文献类型：
--
作者：
Kuramitsu, Kaori;Fukumoto, Takumi;Ku, Yonson
虽然一些出版物报道了捐赠者的发病率，肝功能恶化，这可能会导致术后肝衰竭（PHLF），没有具体评估由国际肝脏外科研究组（ISGLS-PHLF）提出的PHLF的发病率进行了分析257例活体供体。ISGLS-PHLF定义为术后第5天或之后的国际标准化比值增加和高胆红素血症。21例供体（8%）确定为ISGLS-PHLF，其中18例（85.7%）为A级，2例（9.5%）为B级，1例（4.8%）为C级。无ISGLS-PHLF的平均住院时间为15 +/- 1天，随着等级的增加而沿着延长（p = 0.03）。在单变量分析中，右肝切除术与ISGLS-PHLF的发生率显著相关（p = 0.02），在多变量分析中，右肝切除术（p = 0.002）和手术时间（p = 0.01）显著相关。在176例右叶供者中，19例（10.8%）发生了ISGLS-PHLF，其中16例（84.2%）为A级，2例（10.5%）为B级，1例（5.3%）为C级。单变量（p = 0.002）和多变量（p = 0.003）分析显示，手术时间与ISGLS-PHLF的发生率显著相关，右叶捐赠手术与ISGLS-PHLF的发生率较高相关。
Although several publications have reported donor morbidities, deterioration of liver function, which may cause posthepatectomy liver failure (PHLF), was not assessed specifically.The incidence of PHLF proposed by the International Study Group of Liver Surgery (ISGLS-PHLF) was analyzed among 257 living donors. ISGLS-PHLF was defined by an increased international normalized ratio and hyperbilirubinemia on or after postoperative day 5.ISGLS-PHLF was identified in 21 donors (8 %), of which 18 (85.7 %) were grade A, 2 (9.5 %) were grade B, and 1 (4.8 %) was grade C. The average hospital stay without ISGLS-PHLF was 15 +/- 1 days, which extended along with increasing grades (p = 0.03). In univariate analysis, right hepatectomy was significantly associated with the incidence of ISGLS-PHLF (p = 0.02), and right hepatectomy (p = 0.002) and operation time (p = 0.01) in multivariate analysis. Of 176 right lobe donors, 19 (10.8 %) developed ISGLS-PHLF, of which 16 (84.2 %) were grade A, 2 (10.5 %) were grade B, and 1 (5.3 %) was grade C. Operation time was significantly associated with the incidence of ISGLS-PHLF in univariate (p = 0.002) and multivariate (p = 0.003) analyses.Right lobe donation surgery is associated with a higher incidence of ISGLS-PHLF.