Application of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure
10.3760/cma.j.cn113884-20240815-00246
- VernacularTitle:边缘性供肝在慢加急性肝衰竭患者肝移植中的应用
- Author:
Kun DONG
1
;
Cheng ZHANG
;
Junze CHEN
;
Guanmiao CHEN
;
Yongyuan JIAN
;
Ruiling SU
;
Kaiyong HUANG
;
Xuelin TAN
;
Chunqiang DONG
;
Hongwei YANG
Author Information
1. 大连医科大学，大连 116044
- Publication Type:Journal Article
- Keywords:
Acute-on-chronic liver failure;
Liver transplantation;
Marginal donor liver;
Delayed graft function
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(2):81-86
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.
