Effect Of Diversified Fatty Donor Liver On Postoperative Recovery Of Liver Transplantation Patients

Purposes:1.To probe the influence of donor liver with different levels of fat deposits on postoperative recovery of liver function in typical OLT;2.To explore the influence of different levels of fatty liver on postoperative lactic acid clearance;3.To analyze the influence of different levels of fatty liver on the probability of postoperative biliary tract complications.Methodology:74 OLT patients were divided into four groups: normal group,10%-20% group,20%-30% group and >30% group.Measure the values of aspartate aminotransferase(AST),alanine aminotransferase(ALT),prothrombin time(PT)and total bilirubin(TBIL)on Day 1,Day 3,and Day 5 POST-OP,respectively.Measure the lactic acid values of portal and arterial opening by blood gas analysis pre-and during surgery,and calculate the lactic acid clearance rate in 6hs POST-OP.In addition,calculate the probability of postoperative biliary tract complications for all patients,and then compare the obtained data between groups and as a whole.Findings:Day 1 POST-OP: no significant difference in AST,ALT and PT between10%-20% group and normal group,but the values of liver function enzymology index and prothrombin time significantly increased as adiposis degree rises up,with statistical significance(P<0.05).Day 3 POST-OP: no significant difference in AST and ALT between 10%-20%group and normal group,while the liver power value of 20%-30% group and >30%group still higher than that of the first two groups,with difference statistically significant(P<0.05),and the adiposity degree positively correlated with the liver power value.Difference from Day 1 that the prothrombin time was basically the same among all groups,with no statistical difference(P>0.05).Day 5 POST-OP: no significant difference in various indexes between the adjacent groups.However,when the donor liver with >30% adipose-like transformation was compared with the donor liver with less than 30% as a whole,the enzyme indexes were still higher in the group with > 30% adipose-like transformation,and the difference was statistically significant(P<0.05);No significant difference in TBIL among all groups(P>0.05).The lactate clearance rate 6hs POST-OP in the donor liver with moderate fatty degeneration was significantly higher than that in the donor liver with mild fatty degeneration and normal donor liver,with difference statistically significant(P<0.05).The probability of postoperative biliary complications in the moderate steatoid group was 15.4%,which had no significant difference compared with 13.6% in the moderate steatoid group(P<0.05).Conclusions:1.The higher degree of fatty donor liver,the lower rate of postoperative liver function recovery,the coagulation function recovery faster than the enzymological index,and the degree of fatty change does not greatly affect liver bilirubin metabolism;2.The lactate clearance rate of the donor liver with >30% fatty lesion was significantly lower than that with mild fatty lesion and normal liver,but there was no significant difference in the lactate clearance rate between normal liver and mild fatty lesion;3.The degree of donor lipoid does not determine the probability of postoperative biliary complications.