肝移植3种器官保存液的比较研究  

Comparison of three organ preservation solutions in clinical liver transplantation

作　　者：郑卫萍[1] 沈中阳[1] 朱志军[1] 郑虹[1] 邓永林[1] 潘澄[1] 

机构地区：[1]天津市第一中心医院器官移植中心,天津300192

出　　处：《中国现代医学杂志》2008年第18期2704-2708,共5页China Journal of Modern Medicine

基　　金：天津市科技发展计划(No:05ZHTGCG00300)

摘　　要：目的比较UW液、Celsior液和HTK液对移植供肝灌注保存的效果。方法回顾性分析2002年1月～2004年3月施行的成人首次肝脏移植且术前诊断为良性肝病者263例,根据所采用的灌注保存液分为UW液组(161例)、Celsior组(45例)和HTK组(57例),3组患者年龄、性别及原发病分布,术前肝功能指标及分级,肝移植术式及供肝冷,热缺血时间差异均无显著性,比较3组患者术后早期移植肝功能指标、血管及胆道并发症发生率和移植物存活率。结果3组患者肝移植术后早期血清丙氨酸氨基转移酶、门冬氨酸氨基转移酶、碱性磷酸酶和γ-谷氨酰转肽酶差异均无显著性;UW液组术后第7天血清总胆红素(117.4±96.3)μmol/L高于Celsior组[(85.1±77.9)μmol/L,P=0.047]和HTK组[(86.5±82.6)μmol/L,P=0.033];HTK组术后即刻凝血酶原时间(21.9±5.8)s低于UW液组[(24.8±6.2)s,P=0.004]和Celsior组[(26.4±7.0)s,P=0.001];HTK组凝血酶原时间峰值(24.0±5.2)s低于Celsior组[(27.5±6.1)s,P=0.002]。UW液组发生移植肝原发无功能2例(1.2%),但组间差异无显著性(P=0.528)。3组患者术后血管并发症、胆道并发症及排斥反应发生率和再次移植率差异均无显著性。移植物1年及3年存活率分别为:UW液组80.7%和73.9%,Celsior组91.1%和82.2%,HTK组94.7%和80.7%,存活时间差异无显著性(P=0.099)。结论UW液、Celsior液和HTK液对移植供肝灌注保存的效果差异无显著性。[Objective] To compare the efficacy of three organ preservation solutions--University of Wisconsin （UW） solution, Celsior solution and Histidine-Tryptophan-Ketoglutarate （HTK） solution in liver transplantation. [Methods] We reviewed the records of 263 consecutive adult patients with benign end-stage liver diseases undergoing primary liver transplantation from January, 2002 to March, 2004. The patients were divided into UW（161）, Celsior（45） and HTK（57） groups according to graft preservation solutions. Age, sex and primary diseases distribution, pre-operative liver function, Child-Pugh and MELD scores, surgical procedure, cold and warm ischemic time of graft were comparable in the three recipient groups. Post-operative liver function, incidence of vascular and biliary complications, and graft survival were compared among the three groups. [Results] There was no significant difference in serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transferase among the three groups during the first week post-operation. Total serum bilirubin of UW group（117.4±96.3） μmol/ L was higher than Celsior group[（85.1±77.9） μmol/L, P =0.047] and HTK group[（86.5±82.6） μmol/L, P =0.033] on the 7th day post-operation. Immediate post-operative prothrombin time of HTK group （21.9±5.8）s was lower than UW group[（24.8±6.2）s, P =0.004] and Celsior group[（26.4±7.0）s, P =0.001]. Peak prothrombin time of HTK group （24.0±5.2s） was lower than Celsior group[（27.5±6.1 ）s, P =0.002]. 2 cases showed primary non-function which were both in the UW group（1.2%）, but there was no significant difference among the three groups（P =0.528）. Among the three groups, there was no significant difference in the incidence of vascular and biliary comphcations, rejection and retransplantation. The 1- and 3-year graft survival was 80.7% and 73.9% （UW） vs. 91.1% and 82.2% （Celsior） vs. 94.7% and 80.7% （HTK）, and there was no significant difference

关 键 词：肝移植 器官保存液 比较 

分 类 号：R657.3[医药卫生—外科学]