| Objective:To investigate the influencing factors and prognosis analysis of liver regeneration after split liver transplantation.Methods:Patients who underwent split liver transplantation at the Organ Transplant Center of Affiliated Hospital of Qingdao University from January 2015 to July 2021 were collected.According to the inclusion and exclusion criteria,a total of 44 patients were included.According to the intraoperative drainage method and the CAS three-dimensional reconstruction system,the donor liver volume,the resected liver volume,the liver volume at 1 month after the operation,and the liver regeneration rate(LRR)was calculated.According to whether the liver regeneration rate was greater than 100%,they were divided into a good regeneration group(LRR≥100%,24 cases)and a poor regeneration group(LRR<100%,20 cases).To compare the difference of perioperative data and postoperative survival rate between the two groups.Results:(1)Analysis of liver regeneration:The growth rate of the transplanted liver volume was the fastest within 1 month after surgery,and the growth volume reached 3 months after surgery.peak.(2)Analysis of preoperative data and intraoperative conditions of donor and recipient:donor liver steatosis,recipient BMI,splitting method,anhepatic period time,intraoperative blood loss,and intraoperative blood transfusion volume are the factors for liver regeneration after SLT.influencing factors(P<0.05).(3)Analysis of postoperative conditions:the hospital stay and recovery time of liver function in the well-regenerated group were significantly shorter than those in the dysplastic group;the alanine aminotransferase and aspartate aminotransferase in the well-regenerated group were lower than those in the dysplastic group from 1 to 7 days after the operation;Bilirubin levels were lower in the dysplastic group 5 to 7 days after surgery.(4)Comparison of postoperative portal vein flow:on the 1st and 30th day after operation,the portal vein flow per 100 g in the well-regenerated group was lower than that in the poor-regeneration group,and the difference was statistically significant.On the first postoperative day,12 patients(50%)in the good regeneration group had portal vein flow(replaced by A below)60≤A<80ml/min/100g,and 3 patients(15%)in the poor regeneration group,The difference between the two groups was statistically significant(P=0.015);on the 30th day after surgery,there were 16 cases(66.7%)in the well-regenerated group whose portal vein flow(replaced by A~#below)was 40≤A~#<60ml/min/100g),there were 4 cases(20%)in the dysplasia group,and there was a statistically significant difference between the two(P=0.002);(5)Prognosis analysis:the 6-month survival rate in the good regeneration group was 95.8%,and in the dysplastic group after6 months The monthly survival rate was 70%,and the difference in overall survival between the two groups was statistically significant(P=0.012).Conclusion:Splitting method,donor liver steatosis,recipient BMI,anhepatic period time,intraoperative blood loss,intraoperative blood transfusion volume and postoperative portal vein flow are important factors affecting liver regeneration after SLT.The development of individualized surgical plans and early intervention. |
