Abstract:

Objective To explore whether temperature changes at different times in the perioperative period correlate with the incidence of early allograft dysfunction（EAD）. Methods Recipients who underwent liver transplantation in the Eastern Theater General Hospital between December 1，2020， and November 30，2023 wereselected， and perioperative clinical data and temperature data at different times of the recipients were collected， andmeaningful body temperature was identified by propensity score matching with other general information data to analyze the correlation of early graft insufficiency with temperature changes. Results There were 86 cases of EAD among 272 recipients， with an incidence of 31.2%. After 1 ：1 propensity score matching， a total of 56 pairs of recipients were matched: divided into the EAD group （n ＝ 56 cases）， and the NO-EAD group （n ＝ 56 instances）. The temperature change 1 h after the opening of the inferior vena cava in the neo-hepatic phase （△ T4 ） was significantly different between the two groups （t ＝ 2.382，P ＝ 0.019）， and with the optimal truncation value of the ROC curve 0.45 ℃， it was foundthat the incidence of EAD in recipients with △ T4lower than 0.45℃ was 2.901 times higher than that higher than 0.45℃（95% CI ＝ 1.181 ～ 7.125，P ＝ 0.020）. Conclusion Temperature change 1 h after opening of the inferior vena cava in the anhepatic phase has a certain correlation with the early graft insufficiency， and the faster the body temperatureincreases， the earlier the early graft function recovers. The quicker the body temperature rises to its normal temperature，the lower the incidence of early graft insufficiency. Intraoperative temperature changes can reflect the recovery of newliver function at an early stage， and the poor rise of body temperature in the new liver stage should arouse the vigilance of clinicians. 

Key words:

Liver transplantation ,  , Early allograft dysfunction ,  , Temperature change ,  , Propensity score matching

摘要：

目的 探讨围手术期不同时间的体温变化是否与早期移植物功能不全（early allograft dysfunction，EAD）的发生率具有相关性。方法 选取在东部战区总医院 2020 年 12 月 1 日至 2023 年 11 月 30 日期间接受肝移植的 272 例受者，收集受者围手术期临床数据和不同时间的体温数据，通过倾向性评分匹配其他一般资料，找出有意义的体温数据，分析体温变化与 EAD 的相关性。结果 纳入的 272 例受者中 EAD 有 86 例，发生率为 31.2%。经过 1 ：1 倾向评分匹配后，共匹配到 56 对受者，分为 EAD 组（n ＝ 56 例）和 NO-EAD 组 （n ＝ 56 例）。新肝期下腔静脉开放后 1 h 温度变化（△ T）两组之间具有明显差异（t ＝ 2.382，P ＝0.019），取 ROC 曲线的最佳截断值 0.45℃，发现△ T4 低于 0.45℃的受者 EAD 发生率是高于 0.45℃的2.901 倍（95% CI ＝ 1.181 ～ 7.125，P ＝ 0.020）。结论 新肝期下腔静脉开放后 1 h 温度变化与 EAD 具有一定的相关性，体温升高至正常温度越快，EAD 发生率越低，术中体温变化可以反映早期新肝功能的恢复情况，新肝期体温上升不良应引起临床医生的警惕。

关键词:

肝移植 , 早期移植物功能不全 , 温度变化 , 倾向性评分匹配