| Objective:Since 1963,when Thomas Earl Starz finished the first liver transplantation in the world,liver transplantation has become one of the operations that was widely accepted and leading.And also become the standard of treatment of acute and chronic liver failure.The 1 year survival rate can reach 96%.However,the risk of operation and complications have kept many patients away.Especially during operative period,the incidence and mortality of early complications were still high.And some studies found that 14.8%could be achieved,which was related to many factors during and after surgery.To study the related risk factors for early complications after liver transplantation,147 patients of liver transplantation in the first hospital of Jilin university were respectively analyzed in this paper.Methods:The basic information of the patients which may influence the complications was collected in the 147 cases of liver transplantation.The factors of donor include age(years old)and blood type.The factors of receptor were include that of preoperative,intra-operative and postoperative.The gender,age(years old),primary disease,blood type,preoperative total bilirubin(Tbil,umol/L),creatinine(Gr,umol/L),the international standardization ratio(INR),aspartic aminptransferase(AST,U/L),alanine aminotransferase(ALT,U/L),albumin(Alb,g/L),platelet PLT,*10~9 L),neutrophil counts(*10~9 L),lymphocyte count(*10~9 L),hemoglobin(Hb,g/L),fibrinogen(g/L)and the preoperative Meld score,platelet/albumin ratio(PAR),neutrophil/lymphocyte ratio(NLR)were belong to the preoperative factors;Intra-operative factors included thermal ischemia time(s),cold ischemia time(min),intra-operative blood loss(ml),and anhepatic phase(min).Postoperative factors included the AST and ALT of postoperation,12 hours,24 hours,48 hours and 72hours after operation.Early postoperative complications mainly refers to that happened within a month after operation,including hypercholesterolemia,hyperlipidemia,pulmonary edema,cytomegalovirus infection,poor graft function,hypertension,vascular complications,bile duct complications,kidney failure,intraperitoneal hemorrhage,a large number of hydrothorax and seroperitoneum,diabetes,infection,acute rejection and side effect of FK.According to the incident of the total complications,there were complications group and no complications group.So was that of each complications.And then the relationship between related factors and complications was studied.SPSS 19.0 was used for data processing.T test is used in the measurement data group which conforms to normal distribution.A single sample K-S test was used to compare the measurement data of non-conformance distribution.Ac~2 test was used to compare the data sets.Multivariate analysis was performed by Logistic regression analysis of backward LR.Results:There was a statistical difference between the incidence of complications and the Meld score,Alb,PLT,PAR,fibrinogen,TBil,preoperative AST and preoperative ALT in the single factor analysis.Multiple factors analysis showed that the PAR and preoperative AST as independent risk factors for early complications.PAR is strong protection factors whiles the preoperative AST was a strong risk factor of complications.The incidence of complications of high PAR group was3.84 times that of the low PAR group.And that of preoperative AST normal group was only a quarter of the preoperative AST exception group.Further single factor analysis suggested that PAR was associated with vascular complications and biliary complications,while preoperative AST had an effect on pleural effusion.Conclusion:1.The preoperative fibrinogen,PLT,Alb,TBil,PAR,Meld score,AST and ALT had an effect on the early postoperative complications of liver transplantation.2.PAR and preoperative AST are independent risk factors for early complications of liver transplantation.3.PAR was associated with postoperative vascular complications and biliary complications,while the preoperative AST had an effect on postoperative pleural effusion. |
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