心脏死亡者供肝移植术后受体早期肝功能恢复不良的影响因素分析

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Abstract Objective To assessment the risk factors on poor early liver function recovery. of recipient after liver transplantation (LT) using allografts from donation after cardiac death (DCD) or brain and cardiac death(DBCD)donors.Methods In this retrospectively study, 211 liver transplantation using grafts from DCD or DBCD donors were performed at the Third Medical Center, General Hospital of Chinese PLA from September 2013 to January 2017. We collected data of recipient and donor including gender, age, primary disease, ABO blood type, body mass index (BMI), medical history (fatty liver, hypertension), ICU hospitalization time, mechanical ventilation time, warm ischemia time, cold ischemia time, intraoperative blood loss, operation time, Model for End-Stage Liver Disease (MELD) score and indexes of routine laboratory test, et al. Statistical analysis using the chi-square test, multivariate step-wise Cox regression were performed.Results Of the 211 patients, intraoperative blood loss (P=0.046), BMI (P=0.035), MELD score (P=0.000), and donor age (P=0.047), male gender (P=0.028), serum potassium level (P=0.001), extubation to cardiac arrest (P=0.004), as well as donor ICU hospitalization time (P=0.022) all related to the early liver dysfunction after LT. Multivariate step-wise Cox regression showed that the intraoperative blood loss(P=0.001,HR=12.512,95%CI: 2.679-58.434), MELD score(P=0.021,HR=3.991,95%CI: 1.237-12.876)were independent prognostic risk factors.Conclusions Controlling intraoperative blood loss and selecting receptors with MELD score <25 may further improve the early liver function and prognosis of recipients after LT.

Key words： liver transplantation donors after cardiac death donors recipients hepatic insufficiency

Received: 19 April 2021

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	YANG Yang
	JIAO Ning
	CHEN Xinguo
	HAN Yanping
	LI Ziqiang
	ZHANG Qing

Cite this article:

YANG Yang,JIAO Ning,CHEN Xinguo等. Analysis of influencing factors of early poor recovery of liver function after liver transplantation with organ donation for cardiac death[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(9): 790-794.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2021/V32/I9/790

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