小于2个月龄心脏死亡器官捐献供肝在婴幼儿肝移植中的疗效分析

Translated title of the contribution: Efficacy of donation-after-cardiac-death donors aged under 2 months during infantile liver transplantation

Xingqiang Wang, Wei Lu, Yihe Liu, Lixin Yu, Yan Sun, Weili Wang, Hong Qin, Wei Gao

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To explore the clinical effect of donation-after-cardiac-death (DCD)donors aged under 2 months during infantile liver transplantation (LT). Methods: A total of 35 infants undergoing LT at First Central Hospital from June 2012 to June 2015 were retrospectively analyzed. Among them, there were 21 males and 14 females, aged from 4 to 31 months, 33 with biliary atresia, 1 with Caroli's disease and 1 with Alagille syndrome. Thirty five patients were assigned by the Chinese organ allocation and sharing system (COTRS). There were 21 males and 14 females, aged 0.5-60 months and weighing 3-18 kg. Based upon donor age, they were divided into two groups of <2 months (LT, n=12) and ≥2 months (OT, n=23). Hospitalization records, donor data and follow-up profiles were collected. The incidence of postoperative complications was compared between two groups. And Kaplan-Meier method was employed for analyzing the survival of two groups. Results: Height, weight, serum alanine aminotransferase (ALT), total bilirubin (TBIL), height, weight, liver weight and graft to recipient weight ratio (GRWR) were significantly different between two groups (P<0.05). In LT group, there were hepatic artery embolism (n=3), portal vein stenosis (n=1), biliary complications (n=1), postoperative pulmonary infection (n=3), acute rejection or EBV infection (n=0) and CMV infection (n=1); In OT group, hepatic artery embolism (21.7%, 5/23), portal vein stenosis (26.1%, 6/23), biliary complications (13.0%, 3/23), postoperative pulmonary infection (34.8%, 8/23), acute rejection (17.4%, 4/23), EBV infection (34.8%, 8/23) and CMV infection (39.1%, 9/23). No significant inter-group difference existed in the incidence of postoperative complications (P>0.05). Kaplan-Meier survival analysis showed that the 1/3/5-year cumulative survival rates were 91.7% in group A and 91.3% in group OT. There was no significant inter-group difference (χ2=0, P>0.05). Conclusions: DCD donors aged <2 months may be utilized for infantile LT without an elevated incidence of complications and the recipients can obtain satisfactory long-term survivals.

Translated title of the contributionEfficacy of donation-after-cardiac-death donors aged under 2 months during infantile liver transplantation
Original languageChinese (Simplified)
Pages (from-to)876-880
Number of pages5
JournalChinese Journal of Pediatric Surgery
Volume41
Issue number10
DOIs
StatePublished - Oct 15 2020
Externally publishedYes

Keywords

  • Donation after cardiac death
  • Donor liver
  • Infant
  • Liver transplantation

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