目的探讨不同血型患者背驮式肝移植术后肝功能情况。方法选择2010年3月—2012年8月在郑州人民医院肝脏外科行背驮式肝移植术的供体、受体血型完全符合的原发性肝癌患者45例,按照ABO血型系统分为O型组16例、A型组17例、B型组6例、AB型组6例,分析各组患者术后1周的肝功能指标。结果各组患者均顺利完成手术,安返病房,平均手术时间为(8.5±1.9)h,术后并发症发生率为2.2%(1/45)。各组术后1周丙氨酸氨基转移酶(ALT)水平比较,差异有统计学意义(P〈0.05);天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)水平比较,差异均无统计学意义(P〉0.05)。O型组和A型组各出现肿瘤复发患者1例,均于术后1年内死亡。结论背驮式肝移植治疗原发性肝癌效果较好,安全可靠,ABO血型系统可能对患者术后的肝功能及肿瘤复发有一定影响。
Objective To study the liver function of patients with different blood types after piggyback liver transplan- tation. Methods A total of 45 patients admitted from March 2010 to August 2012 with primary liver cancers given piggyback liv- er transplantation were divided, according to ABO blood - group system, into groups O - type ( n = 16), A - type ( n = 17), B - type (n = 6), AB - type ( n = 6). The liver function indexes were analyzed 1 week after operation. Results All patients had successful operations and returned safely to the wards. The mean operative time was ( 8.5 ± 1.9) h, incidence of post - op- erative complications was 2. 2% (1/45). There was significant difference in level of alanine aminotransferase (ALT) between 4 groups 1 week after operation (P 〈 0. 05 ), but there was not in aspartate aminotransferase (AST) or gamma - glutamyl transpeptidase ( γ- GT) ( P 〉 0. 05 ). One patient from group O - type and 1 from group A - type had tumor recurrence and died within 1 year. Conclusion Piggyback liver transplantation has good effectiveness in treatment of primary liver cancer with safety and reliability. ABO blood - group system may have some influence on liver function and tumor recurrence after operation.