ABSTRACT
Objective To compare the clinical efficacy of laparoscopiceft and open left lateral lobe hepatectomy for living donor liver transplantation in children.Methods The retrospective cohort study was conducted.The clinical data of 65 cases (14 males and 51 females) receiving laparoscopic living donor liver resection from October 2016 to October 2018 were analyzed.At the same time,the same number of male and female donors who underwent open left lateral lobe hepatectomy performed by the same group during the same period were randomly selected as the control group.The occurrence of complications and long-term follow-up of physical and mental health were compared between the two groups.Follow-up using outpatient examination and telephone interview was performed to detect postoperative recovery and complications up to November 2018.Results Intraoperative conditions:In the laparoscopic operation group,one donor was converted to open operation due to the confluence of the middle hepatic vein branches bleeding during the operation,and the rest donors successfully completed the laparoscopic left lateral lobe hepatectomy.The operation time of laparoscopic group was (216.0 ± 36.5) min,the amount of bleeding during operation was (56.0 ± 44.3) mL,and the warm ischemia time of donor liver was (6.4 ± 3.8) min.All 65 donors in open operation group successfully completed the operation.The operation time was (167.0 ± 19.7)min,the amount of bleeding was (138.0 ± 59.4) mL,and the time of warm ischemia of donor liver was (1.4 ± 0.5) min.There were significant differences in the above indexes between the two groups (P＜0.05).Postoperative complications:The incidence of incision fat liquefaction was 3.54％ and 2.51％ respectively in laparoscopic group and open group.The time to first anal exhaust after operation of laparoscopic and open groups was (52.3 ± 4.9) h vs.(62.6 ± 4.1) h,P ＜ 0.05.The average length of hospitalization in laparoscopic and open groups was (4.2 ± 0.4) days vs.(5.0 ± 0.6)days,P ＞ 0.05.Conclusions Laparoscopic left lateral lobe living donor liver resection can achieve the same safety as traditional open surgery,and can reduce the physical and mental injury of donors.It is a reasonable choice for living donor liver transplantation.
ABSTRACT
Objective To study the pathological changes of renal grafts from elderly donor in young recipients and to investigate the safety of kidney transplantation from elderly donors.Methods Fourteen elderly kidney donors (with the age >55 years old)and fourteen young recipients (with the age <30 years old)underwent living related donor renal transplantation at the Department of Transplantation of the Second Affiliated Hospital of Guangzhou Medical University from January 2008 to December 2008 were enrolled as the object of study.Every elderly donor kidney was performed time-zero biopsy and every young recipient was performed routine renal graft biopsy 6 months after transplantation.The pathological and structural changes of kidney tissues after renal transplantation from elderly donors were observed.Results The histopathological changes occurred at 6 months after transplantation from elderly kidney donors to young recipients.Compared with those before transplantation,the severity of renal arteriolar lesion and the index of renal arteriolar sclerosis alleviated after transplantation (P <0.05 ), and the ratio of glomerulosclerosis did not change after transplantation (P >0.05 ).The expression of fibronectin (FN)decreased after transplantation,but the difference had no statistical significance (P >0.05 ).The expression of laminin (LN ) decreased after transplantation (P <0.05).Conclusions The histopathological structure of renal graft from elderly donors in young recipients has improved.