Abstract:Objective:To investigate the safety and therapeutic effect of different warm ischemia time (WIT) of non-heart beating (NHBD) liver graft in clinical liver transplantation.
Methods :A retrospective study on 142 NHBD cases which were under different WIT and cold ischemia time (CIT) within 12h was carried out. According to different WIT, the grafts were divided into 3 groups: group Ⅰ, less than 5min (43 cases); group Ⅱ,5-10min (77cases); group Ⅲ, 10-15min (22 cases). The difference in 3 groups in the aspects of the peak value of alanine aminotransferase (ALT), primary liver graft nonfunction (PNF), acute rejection(AR), biliary complications, vascular complications, infection, graft survival rate and recipient survival rate after liver transplantation were compared.
Results:No PNF occurred in 3 groups post-transplantationly. In group Ⅱ only the peak value of AST and infection rate were significantly higher than group I; but there were significant differences between group Ⅲ and group Ⅰin the aspects of peak value of AST, biliary complications, vascular complication, infection rate. The graft survival rate and recipient survival rate in group Ⅲ were significantly shorter than group I and group Ⅱ in follow up time was 8-23 months.
Conclusions:For NHBD with CIT less than 12 h, the maximal safe duration of WIT is 10 minutes. If WIT is over 10 minutes, there will be a significant higher rate of correlative complications, lower graft survival rate and recipient survival rate after liver transplantation.