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Live Donor Partial Hepatectomy for Liver Transplantation: Is There a Learning Curve?

机译:活体供肝部分肝切除术:有学习曲线吗?

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摘要

Background: Donor safety is the first priority in living donor liver transplantation (LDLT).Objective: To determine the characteristics and outcome of live liver donors who underwent donor hepatectomy from January, 1997 to May, 2007 at Massachusetts General Hospital.Methods: 30 patients underwent LDLT between January, 1997 and May, 2007 at our institution.Results: The type of graft was the right lobe (segments 5-8) in 14, left lobe (segments 2-4) in 4, and left lateral sector (segments 2 and 3) in 12 patients. The mean donor age was 36 (range: 26-57) years. The mean follow-up was 48 (range: 18-120) months. No deaths occurred. Overall, 8 (26.6%) patients experienced a total of 14 post-operative complications. Donor complications based on graft type were as follows: left lateral sector (16.7%), left lobe (25%), and right lobe (35.7%). The experience was divided into two periods 1997-2001 (n=15) and 2002-2007 (n=15). Overall complications during 2 periods were 40% and 13.3%, respectively (p<0.001). The incidence of grade III complication also significantly decreased; 66.7% vs 33.3% (p<0.01).Conclusion: Partial hepatectomy in living donors has a learning curve which appears to be approximately 15 cases. This learning curve is not restricted to the surgeons performing the procedure but involves all aspects of patient care.
机译:背景:供体安全性是活体供肝移植(LDLT)的首要任务目的:确定1997年1月至2007年5月在马萨诸塞州总医院接受肝切除的活体肝供体的特征和结果方法:30例患者结果:1997年1月至2007年5月在我们的机构接受了LDLT。 2和3)12例。供体的平均年龄为36岁(范围:26-57岁)。平均随访时间为48(范围:18-120)个月。没有死亡发生。总体上,有8名(26.6%)患者经历了总共14例术后并发症。根据移植物类型的供体并发症如下:左外侧扇形(16.7%),左叶(25%)和右叶(35.7%)。经验分为1997-2001年(n = 15)和2002-2007年(n = 15)两个时期。 2个时期的总体并发症分别为40%和13.3%(p <0.001)。 III级并发症的发生率也明显降低; 66.7%vs 33.3%(p <0.01)。结论:活体供者部分肝切除术的学习曲线似乎约为15例。该学习曲线不仅限于执行该过程的外科医生,还涉及患者护理的各个方面。

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