摘要
目的分析移植物与受体质量比(graft and recipient weight ratio,GRWR)对胆道闭锁患儿亲属活体肝移植术后早期移植物功能及预后的影响。方法回顾性分析天津市第一中心医院2013年2月至2015年4月施行的201例因胆道闭锁接受亲属活体肝移植患儿的临床资料,其中18例为低GRWR组(GRWR <2.0%)受者,160例为中GRWR组(2.0%≤ GRWR<4.0%)受者,23例为高GRWR组(4.0%≤GRWR)受者。比较三组患儿一般资料,采用单因素及多因素logistic回归分析GRWR与术后早期并发症的相关性,并绘制Kaplan-Meier生存曲线对患儿肝移植术后1、12、24个月累积存活率进行分析。结果GRWR<2%与胆道闭锁患儿亲属活体肝移植术后发生早期移植物功能不良存在显著相关性(OR=0.143, 95%可信区间0.022~0.947)。累计生存率分析显示,低GRWR组1、12、24个月生存率分别为88.89%、83.33%、77.78%,明显低于中GRWR组及高GRWR组,差异具有统计学意义(P<0.05)。结论GRWR对儿童亲属活体肝移植手术预后有重要的预测作用,其中GRWR <2.0%是术后早期移植物功能不良及2年病死率的高危风险因素。
Objective To explore the effects of graft and recipient weight ratio (GRWR) on initial graft function and prognosis in pediatric living donor liver transplant children with biliary atresia (BA).Methods The clinical data of 201 pediatric living-donor liver transplant BA recipients at Central Municipal Hospital from February 2013 to April 2015 were retrospectively reviewed.And 18 recipients with GRWR <2.0% served as low-GRWR group while 160 recipients with GRWR≥2.0% and GRWR<4.0% served as normal-GRWR group.Twenty-three recipients with GRWR ≥4.0% served as high-GRWR group.The clinical data were compared among three groups and the association between GRWR and initial graft poor function after living-donor liver transplantation was evaluated by Logistic regression analysis.Furthermore,1/12/24-month cumulative survival rates were analyzed after liver transplantation.Results Logistic regression analysis revealed that GRWR<2% had a positive connection with initial poor graft function (OR=0.143,confidence interval=0.022-0.947).The cumulative surival rates at 1/12/24 months was 88.89%,83.33%,77.78% in low-GRWR group,97.50%,96.25%,96.25% in normal-GRWR group and 95.65% in high-GRWR group.The cumulative survival rates were significantly lower in low-GRWR group than those in other groups (P<0.05%).Conclusions GRWR is a significant prognostic factor for pediatric living-donor liver transplantation.And GRWR<2% is a risk factor for initial poor graft function and 2-year mortality rate after liver transplant.
作者
张馨月
喻文立
乌曼
盛明薇
张楠
丁艺洁
杜洪印
Zhang Xinyue;Yu Wenli;Wu Man;Sheng Mingwei;Zhang Nan;Ding Yijie;Du Hongyin(Tianjin Medical University,Tianjin 300070,China;Department of Anesthesiology,Tianjin First Center Hospital,Tianjin 300192,China)
出处
《中华小儿外科杂志》
CSCD
北大核心
2019年第5期420-425,共6页
Chinese Journal of Pediatric Surgery
基金
国家自然科学基金(81700569)
天津市自然科学基金(17JCYBJC28000)
天津市卫生计生委科技攻关项目(16KG101)
天津市卫生计生委中医中西医结合科研课题(2017056).
关键词
肝移植
胆道闭锁
移植物与受体质量比
预后
Liver transplantation
Biliary atresia
Graft and recipient weight ratio
Prognsis
