Clinical study of treatment for end stage liver alveolar echinococcosis with ex-vivo liver resection and autologous liver transplantation

Abstract

Objective To explore the influence factors of postoperative surviral time of end stage liver alveolar echinococcosis patients treating with ex-vivo liver resection and autologous liver transplantation, and trying to evaluate economical and social benefit. Methods The clinical data of 30 end stage liver alveolar echinococcosis patients treating with ex-vivo liver resection and autologous liver transplantation in the First Affiliated Hospital of Xinjiang Medical University during May 2011 and May 2016 was analyzed retrospectively. Indexes including gender, age, operation time, time of anhepatic phase, erythrocyte transfusion, bleeding volume and urine output during operation, urine output during anhepatic phase, complication and hospital stay after operation, and hospitalization expenses were analyzed. Single-factor analysis was conducted by Kaplan-Meier test and factors which had statistical significance were involved in Cox proportional hazard model for multiple-factor analysis. P<0.05 was deemed statisticaly significant. Results The mean operation time, median time of anhepatic phase, mean erythrocyte transfusion during operation, mean urine output during operation, mean bleeding volume during operation, mean urine output during anhepatic phase, median time of hospital stay and median expenses of hospitalization of 30 patients were (15.3±2.6) h (7.9-22.3 h), 330 min (104-879 min), (11±6) U (0-32 U), (4 020±1 299) mL (450-11 750 mL), (2 498±2 160) mL (400-15 000 mL), (1 397±480) mL (450-3 200 mL) and 33 d (3-183 d), 22 thousand yuan (9-84 thousand yuan), respectively. Postoperative complication developed in 18 patients. The results of single-factor analysis showed that indexes including age, time of anhepatic phase, operation time and urine output during operation were related to postoperative surviral time (P all 0.05). The results of Cox proportional hazard model showed that bleeding volume during operation was an independent risk factor for postoperative surviral time (P<0.05). Conclusions Bleeding volume during operation is an independent risk factor which influences postoperative surviral time of end stage liver alveolar echinococcosis patients treating with ex-vivo liver resection and autologous liver transplantation. This ideal surgical method has good economical and social benefit. Key words: Autologous liver transplantation; Ex-vivo liver resection; Liver alveolar echinococcosis; Survival time; Risk factor