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巴西圣保罗州里贝朗普雷图市一家肝移植单位中等待肝移植患者的特征,尤其考虑Child评分和终末期肝病模型(MELD)评分。

Characteristics of waitlisted patients for liver transplantation at a liver transplantation unit in the city of Ribeirão Preto, São Paulo, Brazil, especially considering Child and Model for End Stage Liver Disease (MELD) scores.

作者信息

Teixeira A C, Souza F F, Sankarankutty A K, Martinelli A L C, Castro E Silva O

机构信息

Special Liver Transplantation Unit, Department of Surgery, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.

出版信息

Transplant Proc. 2007 Mar;39(2):387-9. doi: 10.1016/j.transproceed.2007.01.010.

Abstract

Liver transplantation represents the most effective therapy for patients suffering from chronic end-stage liver disease. Until recently, in Brazil liver allocation was based on the Child-Turcotte-Pugh score and the waiting list followed a chronological criterion. The aim of this study was to show the clinical and laboratory patterns of our patients awaiting a liver transplantation. Seventy-nine medical records were reviewed in January 2005 to classify patients according to their age, sex, cause of cirrhosis, and Child and Model for End Stage Liver Disease (MELD) scores. The mean age of patients was 47 years; 70% were men. The main diagnosis was liver cirrhosis (97%): 27% alcoholic, 26% viral hepatitis, 20% alcoholic plus viral hepatitis, 13% cryptogenic, and 11% other causes. Sixty-three patients (80%) were Child B or C. The average MELD, scores for Child A, B, and C were 10 +/- 5, 13 +/- 3.4, and 21 +/- 4.3, respectively. Nine deaths (11%) on the waiting list occurred in 2005. Among these, 1 patient was Child B with MELD 10, while the others were Child C, with mean MELD scores of 21 +/- 3.8. Twelve patients (15%) received cadaveric orthotopic liver transplantation. Thus, in this small series, the higher MELD scores corresponded to Child C class and mortality on the waiting list.

摘要

肝移植是治疗慢性终末期肝病患者最有效的方法。直到最近,在巴西,肝脏分配是基于Child-Turcotte-Pugh评分,等待名单遵循时间顺序标准。本研究的目的是展示等待肝移植患者的临床和实验室特征。2005年1月,对79份病历进行了回顾,根据患者的年龄、性别、肝硬化病因以及Child和终末期肝病模型(MELD)评分对患者进行分类。患者的平均年龄为47岁;70%为男性。主要诊断为肝硬化(97%):27%为酒精性,26%为病毒性肝炎,20%为酒精性加病毒性肝炎,13%为隐源性,11%为其他原因。63名患者(80%)为Child B或C级。Child A、B和C级的平均MELD评分分别为10±5、13±3.4和21±4.3。2005年,等待名单上有9人死亡(11%)。其中,1例为Child B级,MELD评分为10,其他为Child C级,平均MELD评分为21±3.8。12名患者(15%)接受了尸体原位肝移植。因此,在这个小样本中,较高的MELD评分与Child C级和等待名单上的死亡率相对应。

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