مشکلات شریان کبدی و ورید باب بعد از پیوند کبد در فرد دهنده، چه کودک چه بزرگسال، عوامل خطر، مدیریت و عواقب: مطالعه ای گذشته نگر به سبک کوهورت
Hepatic arterial and portal venous complications after adult and pediatric living donor liver transplantation, risk factors, management and outcome (A retrospective cohort study)
نویسندگان |
این بخش تنها برای اعضا قابل مشاهده است ورودعضویت |
اطلاعات مجله |
Annals of Medicine and Surgery www.annalsjournal.com |
سال انتشار |
2016 |
فرمت فایل |
PDF |
کد مقاله |
12027 |
پس از پرداخت آنلاین، فوراً لینک دانلود مقاله به شما نمایش داده می شود.
چکیده (انگلیسی):
Objectives: Hepatic arterial (HA) and portal venous (PV) complications of recipients after living donor
liver transplantation(LDLT) result in patient loss. The aim of this study was to analyze these
complications.
Methods: We retrospectively analyzed HA and/or PV complications in 213 of 222 recipients underwent
LDLT in our centre. The overall male/female and adult/pediatric ratios were 183/30 and 186/27
respectively.
Results: The overall incidence of HA and/or PV complications was 19.7% (n ¼ 42), while adult and pediatric
complications were 18.3% (n ¼ 39) and 1.4% (n ¼ 3) respectively. However early (<1month) and
late (>1month) complications were 9.4% (n ¼ 20) and 10.3% (n ¼ 22) respectively. Individually HA
problems (HA stenosis, HA thrombosis, injury and arterial steal syndrome) 15% (n ¼ 32), PV problems (PV
thrombosis and PV stenosis) 2.8% (n ¼ 6) and simultaneous HA and PV problems 1.9% (n ¼ 4). 40/42 of
complications were managed by angiography (n ¼ 18), surgery (n ¼ 10) or medically (Anticoagulant and/
or thrombolytic) (n ¼ 12) where successful treatment occurred in 18 patients. 13/42 (31%) of patients
died as a direct result of these complications. Preoperative PVT was significant predictor of these complications
in univariate analysis. The 6-month, 1-, 3-, 5- 7- and 10-year survival rates in patients were
65.3%, 61.5%, 55.9%, 55.4%, 54.5% and 54.5% respectively.
Conclusion: HA and/or PV complications specially early ones lead to significant poor outcome after LDLT,
so proper dealing with the risk factors like pre LT PVT (I.e. More intensive anticoagulation therapy) and
the effective management of these complications are mandatory for improving outcome.
کلمات کلیدی مقاله (فارسی):
پیوند کبد با دهنده زنده، مشکلات شریان کبدی، مشکلات ورید باب، نجات پیدا کردن
کلمات کلیدی مقاله (انگلیسی):
Living donor liver transplantation, Hepatic artery complications, Portal vein complications, Survival
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