{"title":"受体年龄对小儿肝移植术后围手术期并发症的影响:单中心回顾性研究","authors":"Akira Katayama, Satoshi Kimura, Takashi Matsusaki, Hiroshi Morimatsu","doi":"10.18926/AMO/67548","DOIUrl":null,"url":null,"abstract":"<p><p>It has not been clear how recipient age affects the incidence of serious complications after pediatric living donor liver transplantation (LDLT). We investigated the records of 42 pediatric patients receiving LDLT, dividing our sample into two groups: the infant group (aged < 1 year) and the non-infant group (aged ≥ 1 year and ≤15 years). The primary outcome was postoperative complications assessed using the Clavien-Dindo classification. Multivariate analysis using the Cox regression model was applied to adjust for confounding factors in assessing the incidence of Clavien-Dindo grade ≥ III (C-D ≥ III) complications. The incidence of C-D ≥ III complications was higher in the non-infant group (46.2%) than in the infant group (12.5%) (odds ratio 6.00, 95% confidence interval [CI] 1.13-31.88, p=0.03). In multivariate analysis using the Cox regression model, the Graft-to-Recipient Weight Ratio (GRWR) was independently associated with the incidence of C-D ≥ III complications (hazard ratio [HR] 0.62, 95%CI 0.40-0.95, p=0.03), but being an infant was not (HR 0.84, 95%CI 0.35-1.98, p=0.68). In conclusion, the incidence of C-D ≥ III complications was higher in the non-infant group than in the infant group, but this was largely a function of GRWR: multivariate analysis revealed that GRWR was independently associated with complications.</p>","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"78 4","pages":"323-330"},"PeriodicalIF":0.6000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Recipient Age on Perioperative Complications after Pediatric Liver Transplantation: A Single-Center Retrospective Study.\",\"authors\":\"Akira Katayama, Satoshi Kimura, Takashi Matsusaki, Hiroshi Morimatsu\",\"doi\":\"10.18926/AMO/67548\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>It has not been clear how recipient age affects the incidence of serious complications after pediatric living donor liver transplantation (LDLT). We investigated the records of 42 pediatric patients receiving LDLT, dividing our sample into two groups: the infant group (aged < 1 year) and the non-infant group (aged ≥ 1 year and ≤15 years). The primary outcome was postoperative complications assessed using the Clavien-Dindo classification. Multivariate analysis using the Cox regression model was applied to adjust for confounding factors in assessing the incidence of Clavien-Dindo grade ≥ III (C-D ≥ III) complications. The incidence of C-D ≥ III complications was higher in the non-infant group (46.2%) than in the infant group (12.5%) (odds ratio 6.00, 95% confidence interval [CI] 1.13-31.88, p=0.03). In multivariate analysis using the Cox regression model, the Graft-to-Recipient Weight Ratio (GRWR) was independently associated with the incidence of C-D ≥ III complications (hazard ratio [HR] 0.62, 95%CI 0.40-0.95, p=0.03), but being an infant was not (HR 0.84, 95%CI 0.35-1.98, p=0.68). In conclusion, the incidence of C-D ≥ III complications was higher in the non-infant group than in the infant group, but this was largely a function of GRWR: multivariate analysis revealed that GRWR was independently associated with complications.</p>\",\"PeriodicalId\":7017,\"journal\":{\"name\":\"Acta medica Okayama\",\"volume\":\"78 4\",\"pages\":\"323-330\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta medica Okayama\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.18926/AMO/67548\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta medica Okayama","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18926/AMO/67548","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
目前尚不清楚受体年龄如何影响小儿活体肝移植(LDLT)后严重并发症的发生率。我们调查了42名接受LDLT的儿科患者的病历,将样本分为两组:婴儿组(年龄小于1岁)和非婴儿组(年龄≥1岁和≤15岁)。主要结果是使用克拉维恩-丁多分类法评估术后并发症。在评估Clavien-Dindo≥III级(C-D≥III)并发症的发生率时,采用Cox回归模型进行多变量分析,以调整混杂因素。非婴儿组(46.2%)的 C-D ≥ III 级并发症发生率高于婴儿组(12.5%)(几率比 6.00,95% 置信区间 [CI]1.13-31.88,P=0.03)。在使用 Cox 回归模型进行的多变量分析中,移植物与受者体重比(GRWR)与 C-D ≥ III 并发症的发生率独立相关(危险比 [HR] 0.62,95%CI 0.40-0.95,p=0.03),但与婴儿无关(HR 0.84,95%CI 0.35-1.98,p=0.68)。总之,非婴儿组 C-D≥ III 并发症的发生率高于婴儿组,但这在很大程度上与 GRWR 有关:多变量分析显示 GRWR 与并发症独立相关。
Effect of Recipient Age on Perioperative Complications after Pediatric Liver Transplantation: A Single-Center Retrospective Study.
It has not been clear how recipient age affects the incidence of serious complications after pediatric living donor liver transplantation (LDLT). We investigated the records of 42 pediatric patients receiving LDLT, dividing our sample into two groups: the infant group (aged < 1 year) and the non-infant group (aged ≥ 1 year and ≤15 years). The primary outcome was postoperative complications assessed using the Clavien-Dindo classification. Multivariate analysis using the Cox regression model was applied to adjust for confounding factors in assessing the incidence of Clavien-Dindo grade ≥ III (C-D ≥ III) complications. The incidence of C-D ≥ III complications was higher in the non-infant group (46.2%) than in the infant group (12.5%) (odds ratio 6.00, 95% confidence interval [CI] 1.13-31.88, p=0.03). In multivariate analysis using the Cox regression model, the Graft-to-Recipient Weight Ratio (GRWR) was independently associated with the incidence of C-D ≥ III complications (hazard ratio [HR] 0.62, 95%CI 0.40-0.95, p=0.03), but being an infant was not (HR 0.84, 95%CI 0.35-1.98, p=0.68). In conclusion, the incidence of C-D ≥ III complications was higher in the non-infant group than in the infant group, but this was largely a function of GRWR: multivariate analysis revealed that GRWR was independently associated with complications.
期刊介绍:
Acta Medica Okayama (AMO) publishes papers relating to all areas of basic and clinical medical science. Papers may be submitted by those not affiliated with Okayama University. Only original papers which have not been published or submitted elsewhere and timely review articles should be submitted. Original papers may be Full-length Articles or Short Communications. Case Reports are considered if they describe significant and substantial new findings. Preliminary observations are not accepted.