活体供肝再移植中移植物位置改变的影响及其结果。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-01-17 DOI:10.1016/j.transproceed.2024.12.029

Hidekazu Yamamoto , Kaori Isono , Masaki Honda , Yasuhiko Sugawara , Yukihiro Inomata , Taizo Hibi

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引用次数: 0

摘要

肝再移植（reLT）是肝移植失败的唯一治疗方法，由于其技术性质和高危患者的特点，仍然具有挑战性。方法：19例患者行肾移植(二次肾移植，n = 18；第三次移植，n = 1)，1999年至2021年，根据移植前移植与reLT的侧度分为两组(同侧组，n = 9；对侧组，n = 10)。本研究的目的是评估活体供体肾移植患者的短期和长期预后，并比较同侧和对侧移植的移植存活率。结果：肝静脉重建，同侧组8例（88.9%）患者使用受体原有吻合口，对侧组8例（80%）患者在受体下腔静脉上新建吻合口。同侧组门静脉和肝动脉导管分别为2例和2例，对侧组分别为5例和0例。同侧肝动脉和门静脉并发症的总发生率分别为11.1%和11.1%，对侧肝动脉和门静脉并发症的总发生率分别为30%和11.1%。同侧组1、5年移植物存活率分别为70.8%、66.7%，对侧组为70%、70%。结论：在reLT手术并发症和移植物存活率方面，同侧和对侧移植物之间没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Impact of Altered Graft Position During Living Donor Liver Retransplantation and its Outcomes

Introduction

Liver retransplantation (reLT), which is the only treatment for liver graft failure, remains challenging not only because of its technical nature but also because it is performed in high-risk patients.

Methods

Nineteen patients who underwent reLT (second LT, n = 18; third LT, n = 1) between 1999 and 2021 were divided into two groups according to the graft laterality between prior transplantation and reLT (ipsilateral group, n = 9; contralateral group, n = 10). The aim of this study was to evaluate the short- and the long-term outcomes of patients who underwent living donor reLT and compared graft survival between ipsilateral and contralateral grafts.

Results

For hepatic vein reconstruction, the previous anastomotic orifice of the recipient was used in 8 (88.9%) patients in the ipsilateral group, while a new orifice on inferior vena cava of the recipient was created in 8 (80%) patients in the contralateral group. The conduit for the portal vein and hepatic artery were employed in 2 and 2 patients in the ipsilateral group and in 5 and 0 patients in the contralateral group, respectively. The overall incidence of hepatic artery and portal vein complications was 11.1% and 11.1% in the ipsilateral group, and 30% and 11.1% in the contralateral group, respectively. The 1-, 5-year graft survival rates were 70.8%, 66.7% in the ipsilateral group, and 70%, 70% in the contralateral group, respectively.

Conclusions

There was no difference between ipsilateral and contralateral grafts in reLT in terms of surgical complications and graft survival.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.