Risk factors of biliary anastomotic stenosis after liver transplantation from donation after cardiac death and therapeutic strategies
10.3760/cma.j.cn113884-20191209-00403
- VernacularTitle:心脏死亡后器官捐献肝移植患者术后胆道吻合口狭窄影响因素及治疗策略
- Author:
Yang GAO
1
;
Xiaoshan LI
;
Shengning ZHANG
;
Yuanyi MANG
;
Gang REN
;
Jing LIU
;
Laibang LI
;
Jianghua RAN
;
Li LI
Author Information
1. 昆明市第一人民医院 昆明医科大学附属甘美医院肝胆胰血管外科 云南省器官移植研究所，昆明 650000
- From:
Chinese Journal of Hepatobiliary Surgery
2020;26(9):678-682
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the related risk factors for biliary anastomotic stenosis after liver transplantation (LT) from donation after cardiac death(DCD) and therapeutic strategies.Methods:The data of 192 patients who received LT from DCD in First Hospital of Kunming from Jan 2010 to Jun 2018 were retrospectively analyzed. A total of 145 patients were enrolled, 85 males and 60 females, with average age 45 years. There was a biliary anastomotic stenosis in 8 cases and no stenosis in 137 cases. Their Chinese criterion for biliary anatomic stenosis, age, body mass index, liver fat, cold/warm ischemia time, unschedule cardiac arrest time, usage of vasopressors, high sodium in the donor were compared, and stenosis related factors were analysed by Spearman correlation analysis.Results:The stenosis was positively correlated with age ( r=0.229), body mass index ( r=0.204), lipoidosis ( r=0.239), duration of hot ischemia ( r=0.214), total duration of unplanned cardiac arrest ( r=0.401), use of booster drugs ( r=0.237), and preoperative donor hypernatremia ( r=0.557) (all P<0.05). Endoscopic biliary stent implantation is effective in the treatment of biliary anastomotic stenosis and has a high success rate. Conclusions:There are many factors related to biliary anastomotic stenosis after DCD liver transplantation, but the better donor maintenance, shorten cold/ warm ischemia time, improved anastomosis will be helpful to reduce biliary complications.As the same time, endoscopic biliary stent placement is the preferred way to treat biliary anastomotic stenosis.
