Analysis on cause,prevention and treatment of intra-abdominal hemorrhage after liver transplantation:a report of 82 cases
10.3969/j.issn.1674-7445.2016.06.010
- VernacularTitle:肝移植术后腹腔出血原因分析及防治体会（附82例报告）
- Author:
Liang XIONG
1
;
Lijuan LI
;
Yuling AN
;
Xuxia WEI
;
Huimin YI
Author Information
1. 中山大学附属第三医院器官移植重症监护室
- Keywords:
Liver transplantation;
Intra-abdominal hemorrhage;
Risk factor;
Cold ischemia time;
Hemorrhage volume;
Operation time
- From:
Organ Transplantation
2016;7(6):463-466
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the cause,prevention and treatment of intra-abdominal hemorrhage after liver transplantation. Methods Clinical data of 82 patients undergoing liver transplantation were retrospectively analyzed. All participants were divided into the intra-abdominal hemorrhage (n =12)and control groups (n =70). Preoperative parameters including age,model for end-stage liver disease (MELD)score,prothrombin time (PT),prothrombin time international normalized ratio (PT-INR),fibrinogen (FIB),activated partial thromboplastin time (APTT),platelet (Plt) were statistically compared between two groups. Intraoperative hemorrhage volume,cold ischemia time of donor liver, anhepatic phase time and operation time were also compared between two groups. Postoperatively,the mortality rate was compared between two groups. Results Among 82 patients,1 2 (1 5%)presented with intra-abdominal hemorrhage and required twice surgical hemostasis. In the intra-abdominal hemorrhage group,4 cases (33%)died,and 8 (1 1%)died in the control group. No statistical significance was documented between two groups (P>0. 05 ). Age,MELD score,PT-INR, FIB,APTT and PLT did not significantly differ between two groups (all P>0. 05 ). Compared with patients in the control group,those in the intra-abdominal hemorrhage group yielded significantly more blood loss intraoperatively,longer operation time and longer cold ischemia time of donor liver (all P<0. 05 ). Anhepatic phase time did not significantly differ between two groups (P>0. 05 ). Conclusions After liver transplantation,intra-abdominal hemorrhage is associated with longer cold ischemia time of donor liver,more intraoperative blood loss and longer operation time. In order to decrease the incidence of postoperative intra-abdominal hemorrhage,coagulation function should be completely corrected prior to surgery and the surgical skills should also be enhanced.
