不同时期婴幼儿胆道闭锁活体肝移植的预后情况:单中心101例经验分析

华相伟; 夏强; 张建军; 李齐根; 徐宁; 陈小松; 张明; 薛峰; 韩龙志; 王鑫; 夏雷; 罗毅; 沈丛欢; 邢天宇; 奚志峰

doi:10.3969/j.issn.1001-5256.2014.01.006

不同时期婴幼儿胆道闭锁活体肝移植的预后情况:单中心101例经验分析

DOI: 10.3969/j.issn.1001-5256.2014.01.006

上海交通大学医学院附属仁济医院肝脏外科

基金项目:

上海市卫生局新百人计划(XRB-2011029,夏强)；

详细信息

中图分类号: R726.5
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出版历程
- 收稿日期: 2013-10-13
- 出版日期: 2014-01-20

Prognos is of living donor liver transplantation performed during different periods in infants with biliary atresia: a single- center experience with 101 cases

Department of Liver Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine

Research funding:

摘要

摘要:
目的对上海交通大学医学院附属仁济医院肝脏外科2010年前后婴幼儿胆道闭锁活体肝移植预后进行比较分析,旨在探讨不同时期手术的预后情况。方法回顾分析2006年10月至2012年12月间101例婴幼儿胆道闭锁活体肝移植病例资料。根据移植年份的不同将病例资料分为2006-2009年和2010-2012年2组,分析并比较2组术前一般资料、术中情况和预后情况。行Kaplan-Meier生存分析,计量资料的统计采用t检验,计数资料采用Fisher确切概率法和卡方检验。结果 2组术前一般资料差异无统计学意义。2010-2012年组受者术中出血量（t=2.05,P=0.04）和供肝冷缺血时间（t=3.25,P<0.01）显著低于2006-2009年组。2010-2012年组受者术后胆道并发症（χ2=4.27,P=0.04）,肺部感染并发症（χ2=4.47,P=0.03）和急性排斥反应（P=0.03）的发生率显著低于2006-2009年组。2010-2012年组受者术后生存情况明显好于2006-2009年组。2010-2012年组术后1、2年累积生存率分别为88.4%和88.4%,而2006-200...
- 胆道闭锁 /
- 肝移植 /
- 婴儿 /
- 预后
Abstract:
Objective To compared the prognosis between infants with biliary atresia ( BA) who underwent living donor liver transplantation ( LDLT) during 2006- 2009 and 2010- 2012 in the Department of Liver Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine and to evaluate the prognos is of LDLT performed during different periods. Methods A retrospective analysis was performed on the clinical data of 101 infants with BA who underwent LDLT from October 2006 to December 2012. These patients were divided into 2006- 2009 group and 2010- 2012 group according to the year the procedure was performed. The two groups were compared in terms of preoperative general data, intraoperative status, and treatment outcome. The Kaplan- Meier method was used for survival analysis; measurement data were analyzed by t test, and enumeration data were analyzed by Fisher exact probability test and chi- square test. Results The preoperative general data showed no significant difference between the two groups. Compared with the 2006- 2009 group, the 2010- 2012 group had significantly less intraoperative blood loss ( t = 2. 05, P = 0. 04) , a significantly shorter cold ischemia time of donor liver ( t = 3. 25, P < 0. 01) , and significantly lower incidence of postoperative biliary complications ( χ2= 4. 27, P = 0. 04) , pulmonary infection ( χ2= 4. 47, P = 0. 03) , and acute rejection ( P = 0. 03) . The 2010- 2012 group had significantly improved survival compared with the 2006- 2009 group; the 1 and 2 year cumulative survival rates for the 2010- 2012 group were 88. 4% and 88. 4%, respectively, versus 84. 4% and 75% for the 2006- 2009 group. Conclusion The development of surgical techniques, improvement in perioperative management, and standardized follow- up can significantly increase the success rate of surgery and survival rate and reduce postoperative complications in BA patients.
- biliary atresia /
- liver transplantation /
- infant /
- prognosis

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参考文献(24)

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