肝中静脉分支重建对活体肝移植中最小供肝质量与受体体质量比的影响

王琳媛; 蓝翔; 张华; 李宏宇; 刘非; 李波; 魏永刚

肝中静脉分支重建对活体肝移植中最小供肝质量与受体体质量比的影响

Impact of Non-middle Hepatic Vein Reconstruction on the Result of Low Graft-to-recipient Weight Ratio Living Donor Liver Transplantation

摘要

摘要:
目的分析不伴肝中静脉分支(MHVT)重建的活体肝移植(LDLT)患者所需最小供肝质量与受体体质量比(GRWR)。
方法回顾性分析四川大学华西医院2001年1月至2017年11月完成303例LDLT患者临床资料。应用倾向性评分匹配法(PSM)分析伴或不伴MHVT重建LDLT患者所需最小GRWR。
结果通过PSM匹配后，MHVT重建和非重建组在术后并发症，小肝综合征，住院时间，肝功能和凝血功能差异无统计学意义，两组间的1年，3年和5年生存率差异有统计学意义，MHVT重建组患者的短期和长期生存率优于未重建组。
结论对非MHVT重建患者，GRWR应大于0.86%；对MHVT重建患者，GRWR在0.5%~0.6%之间是可接受的。

Abstract:
Objective To analyze of the minimum graft-to-recipient weight ratio (GRWR) required for living donor liver transplantation (LDLT) without middle hepatic vein branch (MHVT) reconstruction.
Methods We retrospectively collected the clinical data and outcomes of 303 LDLT patients over 16 years from 2001 to 2017. The minimum GRWR of non-middle hepatic vein reconstruction was analyzed by propensity score (PSM).
Results With PSM analysis, no significant differences were observed in postoperative complications, SFSS, inpatient time, liver function, and coagulation function, but significant differences in 1-year, 3-year and 5-year survival between MHVT reconstruction and non-reconstruction group. The patients with MHVT reconstruction had better short-term and long-term survival than those without reconstruction.
Conclusion For LDLT patients without HMVT reconstruction, GRWR should be greater than 0.86%; for patients with HMVT reconstruction, GRWR is acceptable between 0.5% and 0.6%.

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