Role of intelligent/interactive qualitative and quantitative analysisthree-dimensional estimated model in donor-recipient size mismatch following deceased donor liver transplantation  

作　　者：Han Ding Zhi-Guo Ding Wen-Jing Xiao Xu-Nan Mao Qi Wang Yi-Chi Zhang Hao Cai Wei Gong 

机构地区：[1]Department of Transplantation,Xinhua Hospital,Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China [2]Department of General Surgery,The Third People’s Hospital of Yangzhou,Yangzhou 225126,Jiangsu Province,China [3]Department of Tuberculosis Control,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China [4]Department of Biliary-Pancreatic Surgery,Shanghai Changzheng Hospital,Second Military Medical University,Shanghai 200003,China [5]Department of Pathology,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China [6]Department of General Surgery,Xinhua Hospital,Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China [7]Shanghai Key Laboratory of Biliary Tract Disease Research,Shanghai,200092,China

出　　处：《World Journal of Gastroenterology》2023年第44期5894-5906,共13页世界胃肠病学杂志（英文版）

基　　金：Supported by National Natural Science Foundation of China,No.82172628。

摘　　要：BACKGROUND Donor-recipient size mismatch(DRSM)is considered a crucial factor for poor outcomes in liver transplantation(LT)because of complications,such as massive intraoperative blood loss(IBL)and early allograft dysfunction(EAD).Liver volumetry is performed routinely in living donor LT,but rarely in deceased donor LT(DDLT),which amplifies the adverse effects of DRSM in DDLT.Due to the various shortcomings of traditional manual liver volumetry and formula methods,a feasible model based on intelligent/interactive qualitative and quantitative analysis-three-dimensional(IQQA-3D)for estimating the degree of DRSM is needed.AIM To identify benefits of IQQA-3D liver volumetry in DDLT and establish an estimation model to guide perioperative management.METHODS We retrospectively determined the accuracy of IQQA-3D liver volumetry for standard total liver volume(TLV)(sTLV)and established an estimation TLV(eTLV)index(eTLVi)model.Receiver operating characteristic(ROC)curves were drawn to detect the optimal cut-off values for predicting massive IBL and EAD in DDLT using donor sTLV to recipient sTLV(called sTLVi).The factors influencing the occurrence of massive IBL and EAD were explored through logistic regression analysis.Finally,the eTLVi model was compared with the sTLVi model through the ROC curve for verification.RESULTS A total of 133 patients were included in the analysis.The Changzheng formula was accurate for calculating donor sTLV(P=0.083)but not for recipient sTLV(P=0.036).Recipient eTLV calculated using IQQA-3D highly matched with recipient sTLV(P=0.221).Alcoholic liver disease,gastrointestinal bleeding,and sTLVi>1.24 were independent risk factors for massive IBL,and drug-induced liver failure was an independent protective factor for massive IBL.Male donor-female recipient combination,model for end-stage liver disease score,sTLVi≤0.85,and sTLVi≥1.32 were independent risk factors for EAD,and viral hepatitis was an independent protective factor for EAD.The overall survival of patients in the 0.85<sTLVi<1.32 grou

关 键 词：Intelligent/interactive qualitative and quantitative analysis-three-dimensional Donor-recipient size mismatch Intraoperative blood loss Early allograft dysfunction 

分 类 号：R657.3[医药卫生—外科学]