成人肝脏移植中扩大标准的供体和标准供体的应用比较  

Adult liver transplantation adopted expanded criteria donor or standard criteria donor:Comparative study

作　　者：王营[1] 杜英东[1] 于建秀[1] 张豪洁 吴伟 姜璐 赵亮 杨强 王晓 WANG Ying;DU YING-dong;YU JIAN-xiu(Department of Hepatobiliary Surgery of PLA,No.107 Hospital,Yantai,Shandong 264002,China)

机构地区：[1]解放军107医院肝胆外科,山东烟台264002

出　　处：《实用医药杂志》2018年第10期874-876,885,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的比较分析肝脏移植中应用扩大标准供体和标准供体后肝脏功能及预后。方法选择2003年12月—2009年12月肝脏移植者126例作为研究对象,其中接受标准供体肝脏肝移植74例,接受扩大标准供体肝脏52例。根据所含风险因子的不同,将扩大标准的供体分为E1(含1～2个风险因子)、E2(含3个以上风险因子)两组,与接受标准供体的74例相比较,分析研究52例接受了扩大标准供体的受体的临床资料及生存情况。结果同标准供体组相比较,接受扩大标准供体组受体术后半年生存率(P>0.05)和1年生存率没有显著差别(P>0.05),但接受标准供体组受体2年生存率优于接受扩大标准供体组受体(P<0.05)。同标准供体组相比较,接受E1组扩大标准供体组受体术后半年生存率(P>0.05)、1年生存率(P>0.05)、2年生存率没有显著差别(P>0.05)。E2组受体术后半年生存率(P<0.05)、1年生存率(P<0.05)、2年生存率(P<0.05)均低于接受标准供体肝脏的受体。Meld评分小于20的患者接受E2组供体术后半年生存率(P>0.05)、1年生存率(P>0.05)、2年生存率(P>0.05)与Meld评分>20的患者接受E1组供体没有显著差异。供肝冷缺血时间>12 h是影响受体生存率的独立危险因素。结论在所含风险因子少于3个的情况下,扩大标准的供体肝脏是可以应用的。含不同数量风险因子的扩大标准供体与不同MELD评分受体的合理匹配是影响受体术后生存率的重要因素。Objective To compare liver funtion and survival rate of liver graft of expanded criteria and standard criteria in a single transplantation centre.Methods The 126 transplant recipients with deceased donor were performed on from January 2003 to June 2009 in author's hospital,which 74 patients received standard criteria donor(SCD);52 patients received different type expanded criteria donors(ECD).According to the different type's risk factors,all the ECDs were divided into two groups:E1 group(with 1 to 2 risk factors)and E2 group(with 3 to 4 risk factors).Survival rates of patients received different type ECDs were compared with patients received SCDs.Results Half a year(P>0.05)and 1 year(P>0.05)survival rates had no significant difference in the patients received E1 group and SCDs.But 2 year survival rates of patients received E1 group ECDs had lower than who received SCDs(P<0.05).Half a year(P<0.05),1 year(P<0.05)and 2 years(P<0.05)survival rates of patients received E2 group ECDs had lower than which received s SCDs.The half a year(P>0.05),1 year(P>0.05)and 2 year(P>0.05)survival rates of patients received ECDs which MELD score>20 score had lower than which MELD score<20 score.Conclusion ECDs can be used safely if the risk factor of donor liver was less than 3.The best match of recipient and ECDs which contained different amount of risk factors,different MELD score of the recipients are regarded as the important factors influencing survival rates of the recipients.

关 键 词：肝脏移植 标准供体 扩大标准的供体 

分 类 号：R654.3[医药卫生—外科学]