The Clinical Risk Factors Of Acutelunginjury After Liver Transplantation

ObjectiveTo discuss the relative risk factors of acute lung injury(ALI) developing in the early stage after liver transplantation.MethodsThe clinical data of the 58 trasplant recipients in our department collected from August 2007 to April 2010 were retrospectively reviewed.The diagnosis criteria to ALI corresponded with The American-European Consnesus Conference 1992 standard was adopted as diagnosis standard.ResultIn all of the 58 cases, 46cases were male and 12cases were female.And 4 cases have received the operation of living donor liver transplantation,the other 54 cases have had orthotopic liver transplantation. Among the 58 patients,12 were diagnosed as hepatic carcinoma, 46 were diagnosed as decompensated hepatic cirrhosis or serious hepatitis. Liver function of 9 patients was B,the other 32 patients was C .And,21 patients had coagulation disorders preoperatively,in all of the patients, the mean bleedy volume or transfusion volume was 5625.86±856.87 milliliters during operation,and the mean nonliver or hypotention period was 91.90±11.19 minutes, the mean value of alanine aminotransferase in the blood was 589.76±239.94 u/L 30 minutes after recovering blood supply of the allograft.24 patients of the 58 cases developed ALI 2±1.5 days after operations, and 23 patients had been cured,1 patients died of adult respiratory distress syndrome(ARDS) and multiple organ system failure(MOSF ) on the 7th day of postoperatively. We had taken principle of statistics test for relating clinical risk factors in all of the 58 cases and found that after giving enumeration data chi square test to the factors of age, gender and donor source(P>0.05),and after giving measurement data independent-samples mean T test to the time of nonliver or hypotention period(P > 0.05) ,it had not statistical significance.And after giving enumeration data chi square test and measurement data independent-samples mean T test to basic disease,having or not coagulation disorders preoperatively, bleedy volume or transfusion volume during the operations and the value of alanine aminotransferase in the blood after recovering blood supply of the allograft(P<0.05) ,it had not statistical significance.Then we gave logistics regression analysis to all of the risk factors which had statistical significance after got tests above and gained the result it had statistical significance also. Conclusiondecompensated hepatic cirrhosis or serious hepatitis, coagulation disorders preoperatively,bleedy volume or transfusion volume over 6000 milliliters, and high alanine aminotransferase during the operation were the important risk factors comtributing to ALI after liver transplantation.