Combined Liver-Intestine Grafts Compared With Isolated Intestinal Transplantation in Children: A Single-Center Experience

被引：17

作者：

Dopazo, Cristina ^{[1
]}

Gupte, Girish L. ^{[1
]}

Sharif, Khalid ^{[1
]}

Perera, M. Thamara P. R. ^{[1
,2
]}

Hartley, Jane ^{[1
]}

Muiesan, Paolo ^{[1
,2
]}

Mayer, David A. ^{[2
]}

Bromley, Peter ^{[3
]}

Bennett, John ^{[3
]}

Kelly, Deidre A. ^{[1
]}

van Mourik, Indra ^{[1
]}

Mckiernan, Patrick ^{[1
]}

Beath, Sue V. ^{[1
]}

Mirza, Darius F. ^{[1
,2
]}

机构：

[1] Birmingham Childrens Hosp, Liver Unit Including Small Bowel Transplantat, Birmingham, W Midlands, England

[2] Univ Hosp Birmingham, Queen Elizabeth Hosp, Liver Unit, Birmingham B15 2TH, W Midlands, England

[3] Birmingham Childrens Hosp, Dept Anesthesia & Crit Care, Birmingham, W Midlands, England

来源：

TRANSPLANTATION | 2012年 / 94卷 / 08期

关键词：

Pediatric intestinal transplantation; Patient survival; Postoperative complications; SMALL-BOWEL; MULTIVISCERAL TRANSPLANTATION; UNITED-STATES; THROMBOCYTOPENIA; FAILURE; STRATEGIES; PREDICTORS; RECIPIENTS; REJECTION; EVOLUTION;

D O I：

10.1097/TP.0b013e318265c508

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Intestinal transplantation is known to be associated with a high risk of early complications and mortality. Methods. We analyzed prospective data of 51 primary small bowel transplantations from December 1999 to August 2009 and identified perioperative factors that impact on early mortality (<= 6 months after transplantation) after isolated intestinal (IITx; n=12) and combined liver-intestinal transplantation (CLITx group; n=39). Results. Ten patients died during the first 6 months after transplantation, all of them in CLITx group (n=10/51, 19%). Multivariate analyses demonstrated intraoperative red blood cell transfusion greater than 70 mL/kg (P=0.019, odds ratio [OR]=13.79) and base excess 30-min after reperfusion less than -16 (P=0.001, OR=14.05), thrombocytopenia (<50,000 per dL) between day 1 and day 15 after transplantation (P=0.047, OR=5.22), and occurrence of vascular complications (P=0.003, OR=8.96) during the posttransplantation period as predictors of early mortality in CLITx group. Conclusion. Risk of mortality at 6 months after intestinal transplantation increased when the liver is included as combined graft. Strategies to reduce mortality such as refining selection for transplantation and early referral before the development of liver failure should be a priority.

引用

页码：859 / 865

页数：7

共 31 条

[1] Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor [J].