Fatores de risco associados à trombose de artéria hepática: análise de 1050 transplantes de fígado

Detalhes bibliográficos
Ano de defesa: 2018
Autor(a) principal: Pinto, Luís Eduardo Veras
Orientador(a): Não Informado pela instituição
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/41540
Resumo: ABSTRACT Hepatic artery thrombosis (HAT) is an important cause of graft loss and ischemic biliary complications. Its incidence ranges from 2 to 9% in adults, with a mortality rate of up to 55%. The risk factors related to HAT have been related to technical aspects of arterial anastomosis and non-surgical factors. The objective of this study was to evaluate the risk factors for the development of TAH. The sample consisted of 1050 cases of liver transplant performed at the Walter Cantídio University Hospital of the Federal University of Ceará from May 2002 to December 2014. A retrospective and cross-sectional study was carried out, and the variables studied in the donor were: age, degree of steatosis, cause of death and blood group; in the recipient, the variables were: age, gender, MELD, CHILD, warm ischemia time (WIT), cold ischemia time (CIT), liver disease etiology and anastomosis technique. Univariate analysis indicated that the variables related to hepatic artery thrombosis are: calculated MELD (p = 0.04) and WIT (p = 0.005). In the multivariate analysis, age of the recipient ≥42 years (OR = 4.96, 95% CI, 2.26-10.93, p = 0.001), pure MELD ≥14.5 (OR = 2.35, 95% CI, 1.07-5.18, p = 0.034) and warm isquemica time ≥35 minutes (OR = 3.85, 95% CI, 1.43-10.38, p = 0.008) are independent risk factors for TAH. In the prevalence ratio test for analysis of the anastomosis as a variable, it was observed that anastomosis in continuous suture has 263% more chance of thrombosis when compared to interrupted suture (p = 0.018). It is concluded that age> 42 years, WIT ≥35 minutes and pure MELD> 14 are risk factors for TAH. Anastomosis in continuous suture increases risk of TAH when compared to anastomosis with interrupted suture. Keywords: Hepatic artery thrombosis. Risk factors. Liver transplant.