Donor safety and remnant liver volume in living donor liver transplantation
Donor safety and remnant liver volume in living donor liver transplantation
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DOI：
10.3748/wjg.v18.i48.7327
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发表时间：
2012-12-28
影响因子：
4.3
通讯作者：
Du, Cheng-You
中科院分区：
文献类型：
--
作者：
Shi, Zheng-Rong;Yan, Lu-Nan;Du, Cheng-You
目的：目的：探讨右叶活体肝移植（LDLT）中供体安全性与残肝体积的关系。本文分析了151例成人肝右叶活体供者（不包括肝中静脉）的临床资料。三组供体的条件在所研究的参数方面匹配良好。计算3组供体术前、术中、术后的资料：第1组残余肝体积（RLV）<35%，第2组RLV 36%~ 40%，第3组RLV > 40%。比较不同残肝体积对术后肝功能恢复及全身状况的影响。结果：计算3组供体的人体学资料、手术时间、术前供体血液检测指标。不同性别、年龄、身高、体重、手术时间的供者间比较差异无统计学意义。根据成都标准肝脏体积公式，组1的总肝脏体积为1072.88 +/- 131.06 mL，组2为1043.84 +/- 97.11 mL，组3为1065.33 +/- 136.02 mL。三组无统计学显著性差异。当残肝体积小于总肝体积的35%时，残肝体积对肝功能恢复和重症监护时间有显著影响。并发症的发生与残肝体积密切相关。结论：为保证供肝安全，右叶活体肝移植中残肝体积应大于标准肝体积（35%）。(C)2012年百世登。All rights reserved.
AIM: To evaluate the relationship between donor safety and remnant liver volume in right lobe living donor liver transplantation (LDLT).METHODS: From July 2001 to January 2009, our liver transplant centers carried out 197 LDLTs. The clinical data from 151 cases of adult right lobe living donors (not including the middle hepatic vein) were analyzed. The conditions of the three groups of donors were well matched in terms of the studied parameters. The donors' preoperative data, intraoperative and postoperative data were calculated for the three groups: Group 1 remnant liver volume (RLV) < 35%, group 2 RLV 36%-40%, and group 3 RLV > 40%. Comparisons included the different remnant liver volumes on postoperative liver function recovery and the impact of systemic conditions. Correlations between remnant liver volume and post-operative complications were also analyzed.RESULTS: The donors' anthroposomatology data, operation time, and preoperative donor blood test indicators were calculated for the three groups. No significant differences were observed between the donors' gender, age, height, weight, and operation time. According to the Chengdu standard liver volume formula, the total liver volume of group 1 was 1072.88 +/- 131.06 mL, group 2 was 1043.84 +/- 97.11 mL, and group 3 was 1065.33 +/- 136.02 mL. The three groups showed no statistically significant differences. When the volume of the remnant liver was less than 35% of the total liver volume, the volume of the remnant had a significant effect on the recovery of liver function and intensive care unit time. In addition, the occurrence of complications was closely related to the remnant liver volume. When the volume of the remnant liver was more than 35% of the total liver volume, the remnant volume change had no significant effect on donor recovery.CONCLUSION: To ensure donor safety, the remnant liver volume should be greater than the standard liver volume (35%) in right lobe living donor liver transplantation. (C) 2012 Baishideng. All rights reserved.