关键词:

教科书结局 , 肝细胞癌 , 肝移植

Abstract:

ObjectiveTo analyze the independent risk factors for achieving a textbook outcome （TO） inliver transplant （LT） surgery for patients with hepatocellular carcinoma. MethodsRetrospective analysis of clinical diagnosis and treatment data of patients with HCC who underwent LT in the Liver Transplantation Department of Sun Yatsen Memorial Hospital， Sun Yat-sen University from June 2019 to December 2022 was performed. A total of 134 patients were included， including 124 males and 10 females， with a median age of 54（47 ～ 60） years. According to whether TO was achieved， they were divided into the TO group （n ＝ 41） and the non-TO group （n＝ 93）. Univariate and multivariatelogistic regression analyses were used to identify independent factors affecting TO. ResultsApproximately one-third（30.6%） of hepatocellular carcinoma patients achieved tumor obliteration （TO） after liver transplantation （LT）. Multivariate analysis showed that preoperative bilirubin ≥ 54.1 mmol/L （OR ＝ 9.75，95% CI ＝ 2.01 ～ 47.28，P ＝ 0.005） and biliary stasis in donor liver （OR ＝ 2.93，95% CI ＝ 1.21 ～ 7.13，P ＝ 0.018） were independent risk factors for achieving TO. Further analysis revealed no statistical difference in long-term survival rates between the TO group and non-TO group （χ2 ＝ 1.127，P ＝ 0.288）. ConclusionPreoperative high serum bilirubin and cholestasis in the donor liver areindependent risk factors for achieving TO after liver transplantation in patients with hepatocellular carcinoma. Currently， no differences have been found in the long-term survival rates between different groups. As a comprehensive indicator of shortterm prognosis，TO can be used to compare the quality of nursing among different centers after liver transplantation.

Key words:

Textbook outcome, Hepatocellular carcinoma, Liver transplantation sequencing