【摘要】 目的:分析心脏死亡器官捐献(DCD)肝移植受者术后胆道并发症发生的高危因素。方法:收集浙江大学医学院附属第一医院2010年10月—2013年10月施行的109例DCD肝移植手术的临床资料,回顾分析供者因素对受者胆道并发症的影响。结果:109例DCD肝移植受者术后共24例发生胆道并发症,发生率为22.0%。单因素分析显示胆道并发症组与对照组间的热缺血时间(P<0.001)及ICU住院天数(P=0.013)差异均有统计学意义;ABO血型是否相容差异无统计学意义(P>0.05);使用升压药及患者脂肪肝有增加术后胆道并发症的趋势。多因素分析显示热缺血时间(P=0.001,OR=1.328,95%可信区间为1.124~1.526)和ICU住院天数(P=0.012,OR=0.840,95%可信区间为0.732~0.963)是术后胆道并发症的独立危险因素。结论:胆道并发症仍然是DCD肝移植术后的主要难题,热缺血时间和ICU治疗是受者术后胆道并发症的独立危险因素。在供肝紧缺的情况下,使用ABO血型不相容的供肝不失为拯救生命的有效方法。更多还原

【Abstract】 Objective:To analyze the risk factors for biliary complications of liver transplantation from donation after cardiac death(DCD).Methods:Clinical data of109 patients undergoing liver transplantation from DCD in First Affiliated Hospital of Zhejiang University School of Medicine from October 2010 to October 2013 were studied retrospectively.The risk factors of biliary complications following DCD liver transplantation were analyzed.Results:Twenty-four(22%) patients developed biliary complications after DCD liver transplantation.Univariate analysis showed that biliary complications were associated with warm ischemia time(P <0.001) and length of ICU stay(P = 0.013),but not associated with ABO blood types match(P > 0.05).Administration of inotropic agents and fatty liver increased the trend of biliary complications.Multivariate analysis demonstrated that warm ischemia time and length of ICU stay were independent risk factors for predicting biliary complications.Conclusion:Warm ischemia time and days of ICU stay are independent risk factors for predicting biliary complications after DCD liver transplantation.更多还原