Title Eksplantacija dijela jetre sa živog donora Title (english) Living donor liver transplantation Author Petra Dombaj Mentor MATE ŠKEGRO (mentor)Committee member Tomislav Luetić (predsjednik povjerenstva)Committee member Tomislav Meštrović (član povjerenstva)Committee member MATE ŠKEGRO (član povjerenstva)Granter University of Zagreb Defense date and country 2016-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Broj eksplantacija sa živih donora raste svakim danom sve više, a zajedno s tim raste i zabrinutost za morbiditet i mortalitet kod donora. Važan je izbor prikladnog donora da se smanji rizik od komplikacija kod donora, no isto tako da se i poveća preživljenje primatelja, a i grafta.
Cilj ovog istraživanja bio je saznati koji su mogući donori i koji je razlog isključivanja za eksplantaciju. Drugo, utvrditi koje su kirurške komplikacije bile prisutne kod donora. Znajući najčešće razloge
... More isključivanja donora važno je za transplantacijski centar, jer može skratiti vrijeme tokom evaluacije. Znajući ishode, možemo biti spremni za moguće komplikacije a isto tako, mogućim donorima možemo objasniti komplikacije.
Istraživanje je retrospektivno, temeljeno na analizi podataka dobivenih iz dostupne medicinske dokumentacije bolesnika podvrgnutih eksplantaciji jetre u Zavodu za hepatobilijarnu kirurgiju i transplantaciju abdominalnih organa Kliničkog bolničkog centra (KBC) Zagreb, u razdoblju od 5.rujna 2001. godine (kada bila prva pedijatrijska LDLT u KBC Zagreb) do 2. listopada 2013. godine. Svi podaci su obrađeni u Microsoft Excelu i prikazani, tablično, grafički i tekstualno.
Od 36 mogućih donora, 21 su bili muški, 15 su bile žene, prosjek godina 35,06. 15 od 36 bilo isključeno za donaciju dok 21 prihvaćeno. Najčešći razlozi isključenja bili su masna promjena jetre i vaskularne varijacije u opskrbi jetre. Od 17 donora koji podvrgnuti LDLT, 14 su bili roditelji a od ostalog srodstva bili baka i stric. Jedan donor je bio anoniman. 3 donora bili su inkompatibilnih krvnih grupa. 7 (43,75%) je imalo komplikacije od kojih su po 2 bile I stupnja (Clavien skala), II i IIIa stupnja, a jedna IIIb. Nije bilo IV stupnja komplikacija ni smrti. Većina komplikacija riješeno je spontano, neke zbrinute ne operativno ili s konzervativnom terapijom. Medijan hospitalizacije bio 10,5 dana.
Rezultati predoperativne evaluacije u našem centru slični su s rezultatima drugih transplantacijskih centara. Smrtni slučaj nije zabilježen dok su ukupni morbiditeti trenutačno 43,75%. Slabost istraživanja je mali broj ispitanika pa ovo ne možemo prikazati kao morbiditetnu stopu. Također, nedostaju slična istraživanja na našem području za usporedbu. Less Abstract (english) The number of living donor liver transplantation (LDLT) performing centers grows every day so there is also a growing concern about the donor morbidity and mortality. The selection of a suitable donor is essential to decrease the risk of complications for the donors but also to increase the survival of both, the recipient and the graft.
The aim of this study was to determine the adequacy of donors and reasons of their potential inadequacy. The second aim of this study was, to
... More determine surgical outcomes of the donor? Knowing the most frequent reason of a donor elimination is important for a transplantation center to gain time during the evaluation process and knowing outcomes helps to be prepared for possible complications. Also, potential donors can be familiar with the risks if they decide to be living donors.
Medical documentation was obtained, retrospectively, for 36 potential donors out of which 17 were suitable for donation and underwent LDLT in the period from 5. September 2001. (when the first pediatric LDLT was performed in our center) to 2. October 2013. All data was processed in Excel and presented in tables.
Out of 36 evaluated potential donors, 15 females and 21 males, average age 35,06 years, 15 were unsuitable for donation and 21 were suitable. The most common reason for unsuitable donation was fatty liver and vascular variants of the liver. Out of 17 donors who underwent LDLT, 14 were parents, and other siblings were grandmother and uncle. One donor was unrelated to the recipient. 3 donors had incompatible blood group with recipient. 7 (43,75%) donors had complications out of which 2 were grade I (Clavien scale), 2 grade II, 2 grade IIIa and 1 grade IIIb. There were no grade IV and V. The average stay in hospital was 10,5 days. The majority was managed nonoperatively and resolved spontaneously or with conservative therapy. Only in one case reoperation was necessary.
The results of preoperative evaluation in our center are similar with those in the rest of the transplantation center. The mortality rate is 0% and total major and minor donor morbidities are currently 43,75%. The weakness of this study is small number of donors to take that as morbidity rate. Also, there is a lack of similar studies with postoperative results in our area for comparison. Less Keywords
eksplantacija sa živog donora
Clavien skala
evaluacija donora
Keywords (english)
LDLT
Clavien scale
evaluation of donors
Language croatian URN:NBN urn:nbn:hr:105:885972 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2017-08-22 08:10:41
