移植物体积对小肝综合征发生影响的Meta分析  

A Meta-analysis of effect of graft volume on occurrence of small liver syndromes

作　　者：杨文鑫 偰光华 Yang Wenxin;Xie Guanghua(Hepatobiliary and Pancreatic Surgery,The Hospital of Yanbian University,Yanji Jilin 133000,China)

机构地区：[1]延边大学附属医院肝胆外科,延吉133000

出　　处：《河南外科学杂志》2023年第1期28-33,共6页Henan Journal of Surgery

摘　　要：目的 探讨移植物体积与小肝综合征(SFSS)发生的关系。方法 检索PubMed、Web of Science、中国知网和万方数据库中有关移植物体积与SFSS发生的相关文献,并按照纳入和排除标准筛选,利用RevMan5.3软件进行统计分析。结果 共纳入16篇文献,其中活体肝移植患者3 400例。Meta分析结果显示:小尺寸移植物(SFSG)可增加SFSS发生的风险,差异有统计学意义(Z=5.90,P<0.00001,OR=2.48,95%CI为1.84~3.36)。亚组分析提示:移植物体积对不同人种发生SFSS的影响(Z=5.43,P<0.00001,OR=2.81,95%CI为1.93~4.08);移植物体积对不同移植物类型发生SFSS的影响(Z=3.39,P=0.0007,OR=2.34,95%CI为1.43~3.83);移植物体积对不同年份发生SFSS的影响(Z=5.28,P<0.00001,OR=2.95,95%CI为1.97~4.41)。结论 SFSG是导致SFSS发生的危险因素。SFSG对亚洲人种有较高致SFSS率。选择状况良好的右叶作为移植物,移植物GRWR<0.8%相对安全,SFSS发生率较低。随着对SFSG管理使用的进步,采用SFSG进行活体肝移植数量逐渐增加,SFSS发生率并无显著提升。Objective To study the relationship between graft volume and the occurrence of small liver syndromes(SFSS).Methods PubMed Web of Science CNKI and Wanfang databases were searched for relevant literature on graft volume and the occurrence of small liver syndrome, and were screened according to the inclusion and exclusion criteria, and RevMan5.3 software was used for statistical analysis.Results A total of 16 articles were included, including 3400 patients undergoing living donor liver transplantation. Meta-analysis results showed that SFSG could increase the risk of SFSS, and the difference was statistically significant(Z=5.90,P<0.00001,OR=2.48,95%CI:1.84~3.36). Subgroup analysis showed that the effect of graft volume on the occurrence of SFSS in different races(Z=5.43,P<0.00001,OR=2.81,95%CI:1.93~4.08);the effect of graft volume on the occurrence of SFSS in different graft types(Z=3.39,P=0.0007,OR=2.34,95%CI:1.43~3.83);the effect of graft volume on the occurrence of SFSS in different years(Z=5.28,P<0.00001,OR=2.95,95%CI:1.97~4.41).Conclusion SFSG is a risk factor for the occurrence of SFSS;SFSG has a higher incidence of SFSS in Asians;the right lobe in good condition is selected as the graft, and the graft GRWR<0.8% is relatively safe, and the incidence of SFSS is low;Advances in the management and use of SFSG, with an increase in the number of living donor liver transplants performed with SFSG, without a significant increase in the incidence of SFSS.

关 键 词：移植物体积 SFSG SFSS 

分 类 号：R575[医药卫生—消化系统]