活体肝移植供体的因子5和因子2杂合阳性与并发症。

Northern clinics of Istanbul Pub Date : 2023-09-26 eCollection Date: 2023-01-01 DOI:10.14744/nci.2023.49354
Ender Anilir, Alihan Oral, Tolga Sahin, Fatih Turker, Yildiray Yuzer, Yaman Tokat
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摘要

目的:因子2和因子5突变是最常见的促凝血遗传疾病之一,并在供体准备中进行常规评估。纯合突变是手术禁忌,但杂合突变不能说是一种障碍。我们旨在研究F2和/或F5杂合基因突变对并发症的影响。方法:对210例活体供肝者进行检查。对21名供体患者和30名肝脏接受者的因子2和5杂合阳性供体的可用数据进行了评估。将杂合阳性组与对照组在年龄、性别、住院时间、术后深静脉血栓形成、肺栓塞、门静脉血栓、胆管狭窄和胆漏并发症、肺部感染和肺不张、伤口感染等方面进行统计学比较。此外,对这些患者进行了实验室测试方面的统计比较。此外,对植入突变移植物的受体的并发症进行了统计和数值评估。结果:在统计学上,杂合突变供体组的住院时间比对照组长。血红蛋白和白蛋白血液水平较低(p=0.031,p=0.016);在统计学上,对照组的INR和ALT水平高于具有杂合突变的供体组(p=0.005,p=0.047)。在受体的胆道并发症和肝血管血栓形成方面,杂合突变组之间没有统计学上的显著差异。结论:考虑到存在这些突变的患者住院时间较长,应考虑在这一过程中对治疗的需求增加以及对肝功能的密切随访。
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Factor 5 and Factor 2 heterozygous positivity and complications in living donor liver transplant donors.

Objective: Factor 2 and Factor 5 mutations are among the most common procoagulant genetic disorders and are routinely evaluated in donor preparation. Homozygous mutations are contraindicated for surgery, but heterozygous mutations cannot be said to be an impediment. We aimed to investigate the effect of heterozygous gene mutation of F2 and/or F5 on complications.

Methods: In our study, 210 living liver donors were examined. The available data of Factor 2 and 5 heterozygous positive donors were evaluated in terms of 21 donor patients and 30 liver recipients. The heterozygous positive group and the control group were statistically compared in terms of age, gender, length of hospital stay, post-operative deep vein thrombosis, pulmonary embolism, portal vein thrombosis, bile duct stenosis and bile leakage complications, lung infection and atelectasis, and wound infection. In addition, these patients were statistically compared in terms of laboratory tests. In addition, complications in recipients implanted with mutant grafts were evaluated statistically and numerically.

Results: Hospital staying was longer statistically in the donor group with heterozygous mutations than in the control group. Hemoglobin and albumin blood levels were lower (p=0.031, p=0.016); INR and ALT levels were higher (p=0.005, p=0.047) statistically in the control group than in the donor group with heterozygous mutations. There was no statistically significant difference between heterozygous mutant groups in terms of biliary tract complications and hepatic vessel thrombosis in recipients.

Conclusion: Considering the longer hospital stay in the presence of these mutations, the increased need for treatment in this process and the close follow-up of liver functions should be considered.

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