摘要
目的探讨脂肪肝临床肝移植的疗效，为边缘供肝的使用提供科学依据。方法自2002年至2011年407例供肝中筛选出80例脂肪肝。其中男性69例，女性ll例。年龄20～54岁不等。80例中有16例重度脂肪变性（≥60％）供肝因合并严重灌注性损伤而予剔除，其余64例脂肪变性供肝（steatosis liver donor，SLD）按脂肪肝严重程度分为轻s1组（〈30％，n-22）、中s2组（30％～50％，n-25）、重s。组（≥600A，n=17）。随机抽取无脂肪肝80例作为so对照组。结果so组、s-组、S。组、S。组移植物早期肝功能延迟恢复发生率分别为5Voo、9．1％、20％、29．41％。S。组2例发生原发性无功能（PNF）占11．76％（2／17），占sI。D移植后PNF发生率的3．12％（2／64）。结论SLD移植后移植物早期肝功能延迟恢复的发生率以及近期并发症发生率虽较无脂肪变性者高，但不影响移植后疗效。S1～S2组移植术后1年内死亡率与SLD无相关性。重视SLD移植后并发症的处理，特别是加强术中、术后缺血再灌注损伤的防治，改善微循环，加强护肝治疗，减少近期免疫制剂用量，可取得与正常供肝同样移植疗效。
Objectives To investigate the results of liver transplantation using steatosis liver donors in order to provide a scientific basis for the use of marginal donors. Methods From 2002 to 2011, 80 of 407 were steatosis liver donors. There were 69 males and 11 females. Their age ranged from 20-54 years old. Sixteen donor livers with severe fatty liver and reperfusion injury were not used. The remaining 64 livers were divided into a S1 group （mild steatosis, n=22）, a $2 group （moderate steatosis, n=25）, and a $3 group （severe steatosis, n=17）. A So group was used as a control （ran domly selected fat-free liver, n=80）. Results The occurrence rates of delayed graft function （DGF） in the So , $1 , $2 , $3 groups were 5%, 9.1%, 20%, 29.41%, respectively. Primary nonfunctioning occurred in 2 cases of the $3 group, which represented a 11.76o/oo of the $3 group （2/17）, and 3.12% of the total 64 cases （2/64）. Conclusions Although the incidence rate of DGF was higher in the steatosis liver donor groups than the So group, there was no correlation in the mortality rate of the $1- $3 group within one year of transplantation. Attentions should be paid to the treatment of complica tions after steatosis liver transplantation. By minimizing ischemia-reperfusion injury, improving microcirculation, strengthening routine therapy and reducing the amount of immunosuppression, the same results could be achieved using steatosis donor liver and normal liver tor transplantation.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2013年第2期105-107,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
肝移植
脂肪变性供肝
Liver transplantation
Steatosis liver donor
