Adult Living Liver Donors have Excellent Long-Term Medical Outcomes: The University of Toronto Liver Transplant Experience
Adult Living Liver Donors have Excellent Long-Term Medical Outcomes: The University of Toronto Liver Transplant Experience
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DOI：
10.1111/j.1600-6143.2009.02950.x
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发表时间：
2010-02-01
影响因子：
8.8
通讯作者：
Therapondos, G.
中科院分区：
文献类型：
--
作者：
Adcock, L.;Macleod, C.;Therapondos, G.
右叶活体肝移植是治疗终末期肝病的有效方法。尽管有1年供体发病率和死亡率的报道，但对1年后的结局知之甚少。我们的目标是分析在我们中心进行的前202名连续供体的结局，至少随访12个月（范围12-96个月）。前瞻性记录所有身体并发症，并根据改良的Clavien分类系统进行分类。捐献者在术后2周、1、3和12个月以及此后每年由专门的家庭医生就诊。该队列包括108名男性和94名女性（平均年龄37.3 ± 11.5岁）。供体存活率为100%。在术后第一年内，共有39.6%的供体发生了医学并发症（21例1级，27例2级，32例3级）。1年后，3名供体发生医学并发症（1例1级、1例2级、1例3级）。所有捐助者返回捐赠前就业或研究，虽然四个捐助者（2%）经历了精神并发症。这项前瞻性研究表明，活体肝脏捐献可以安全地进行，没有任何严重的晚期医疗并发症，并表明长期随访可能有助于有利的供体结局。
Right lobe living donor liver transplantation is an effective treatment for selected individuals with end-stage liver disease. Although 1 year donor morbidity and mortality have been reported, little is known about outcomes beyond 1 year. Our objective was to analyze the outcomes of the first 202 consecutive donors performed at our center with a minimum follow-up of 12 months (range 12-96 months). All physical complications were prospectively recorded and categorized according to the modified Clavien classification system. Donors were seen by a dedicated family physician at 2 weeks, 1, 3 and 12 months postoperatively and yearly thereafter. The cohort included 108 males and 94 females (mean age 37.3 +/- 11.5 years). Donor survival was 100%. A total of 39.6% of donors experienced a medical complication during the first year after surgery (21 Grade 1, 27 Grade 2, 32 Grade 3). After 1 year, three donors experienced a medical complication (1 Grade 1, 1 Grade 2, 1 Grade 3). All donors returned to predonation employment or studies although four donors (2%) experienced a psychiatric complication. This prospective study suggests that living liver donation can be performed safely without any serious late medical complications and suggests that long-term follow-up may contribute to favorable donor outcomes.