Relationship between hepatic arterial buffer response and early biliary complications and small-for-size syndrome after living donor liver transplantation
10.3760/cma.j.issn.1007-8118.2012.06.004
- VernacularTitle:活体肝移植术后肝动脉缓冲效应与胆道并发症及小体积综合征的关系
- Author:
Daohai QIAN
;
Qin LIU
;
Xiaohui WANG
;
Chunpeng PAN
;
Baiyong SHEN
;
Guoqing BAO
;
Yiqiao WANG
;
Chenghong PENG
;
Zhecheng ZHU
;
Xiaxing DENG
;
Qian ZHAN
;
Hongwei LI
- Publication Type:Journal Article
- Keywords:
Living donor liver transplantation;
Small-for-size syndrome (SFSS);
Hepatic arterial buffer response (HABR);
Early biliary complications
- From:
Chinese Journal of Hepatobiliary Surgery
2012;18(6):411-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the relationship between hepatic arterial buffer response (HABR),recovery of liver function,early biliary complications and small-for-size syndrome (SFSS).Methods Early hepatic hemodynamic parameters (including hepatic arterial flow (HAF),portal venous flow (PVF) were measured using duplex Doppler sonography in 34 patients who received living donor liver transplantation (preoperatively n＝26,intraoperatively n=26) and on postoperative days 1,2,3,and 7.Alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBIL) level were measured preoperatively and on postoperative days 1,2,3,7,14,21,and 28.If TBIL level was elevated,we used B ultrasonography or CT and even ERCP to diagnose early biliary complications.The days taken for AST,AI T and TBIL to recover and the number of patients with early (＜60 days) biliary complications (bile leakage or bile stricture) and with small-for-size syndrome (SFSS) were recorded.Results Passive hepatic artery buffer response (HABR) was present in 11 patients early after living donor liver transplantation (group 1) and it disappeared in 23 patients (group 2).The recovery in days taken for normalization of AST (10.6± 8.8),AIT (11.6±9.0) and TBlL (average of 29) in group 1 were shorter than in group 2.However,the differences did not reach statistics difference (P＞0.05).The overall incidences of early biliary complications and small-for-size syndrome (SFSS) in group 1 were significantly lower than in group 2 (P=0.04).The survival rate in group 1 was 82 ％,compared with 74 ％ in group 2.Conclusions Passive hepatic arterial buffer response (HABR) disappeared in some patients early after living donor liver transplantation.There were high incidences of early biliary complications and small-for-size syndrome (SFSS) in these patients.Measurcment of hepatic buffer response in the early stage after living donor liver tranaplanta tion is valuable for predition of early biliary complications and small-for-size syndrome (SFSS),thus helping to prevent failure in transplantation.
