Abstract:

ObjectiveTo investigate the potential relationship between fibrin degradation product （FDP）levels and the development of biliary complications （BC） after liver transplantation， and to summarize the riskfactors associated with the development of BC. Methods A retrospective cohort study was conducted in patients undergoing liver transplantation from January 2015 to July 2022 in the Southwest Hospital， Army Medical University and Sichuan Provincial People's Hospital. Demographic data， clinical indicators， and prognostic follow-up informationof patients were analyzed. Overlap weighting （OW） was used to reduce bias. Receiver operating characteristic （ROC） curves were applied to define the cutoff value of FDP. The value divided patients into high- and low-FDP groups. Logistic regression identified risk factors. ResultsA total number of 491 patients were enrolled， and 79（16.1%） suffered from BC. Multivariable logistic regression revealed that FDP ＞ 10.65 mg/L and MELD score ＞ 15 were associated with BCs after OW. ConclusionHigh FDP had significant effect on the risk of BC occurrence and FDP ＞ 10.65 mg/L was an independent risk factor for BC. 

Key words:

Liver transplantation, Biliary complication, Fibrin degradation product, Overlap weighting

摘要：

目的 研究纤维蛋白（原）降解产物（fibrin degradation product， FDP）水平与肝移植术后胆道并发症（biliary complications， BC）发生之间的潜在关系，总结 BC 发生的相关危险因素。方法 回顾性分析 2015 年1 月— 2022 年 7 月陆军军医大学第一附属医院和四川省人民医院 491 例肝移植的人口统计学资料、临床指标和预后随访信息。采用重叠加权（overlap weighting，OW）平衡各组患者中的混杂因素。利用接受者操作特性（receiver operating characteristic， ROC）曲线来确定 FDP 的最佳临界值。Logistic 回归模型分析影响预后的危险因素。结果 491 例患者中 79 例（16.1%）发生 BC。OW 后多因素 Logistic 回归结果显示，FDP ＞ 10.65 mg/L、MELD 评分＞ 15 分为术后 BC 发生的独立危险因素（均 P ＜ 0.05）。结论 高水平的 FDP 对 BC 发生风险有显著影响，FDP ＞ 10.65 mg/L 为 BC 发生的独立危险因素。 

关键词:

 , 肝移植 , 胆道并发症 , 纤维蛋白（原）降解产物 , 重叠加权