Song M-K, Chung J-S, Kim S, Seol Y-M, Kim S-G, Shin H-J, Choi Y-J, Cho G-J
Department of Hematology-Oncology, Busan Cancer Center, Pusan National University Hospital Medical Research Institute, Busan, Korea.
Transplant Proc. 2010 Nov;42(9):3717-22. doi: 10.1016/j.transproceed.2010.08.041.
The hepatic artery resistance index (HARI) reflects portal venous blood pressure and resistance in several diseases of the liver. This study investigated whether preconditioning HARI values would predict hepatic complications such as hepatic graft-vs-host disease (GvHD), veno-occlusive disease, and drug- and sepsis-related hepatotoxicity after allogeneic stem cell transplantation (SCT). Fifty-nine patients who underwent allogeneic SCT were studied to determine whether pre-SCT HARI would predict post-SCT hepatic complications. Twenty-six patients (44.1%) had high HARI values (≥0.74) before allogeneic SCT. At univariate analysis, a high HARI value correlated with incidence of hepatic GvHD. Multivariate analysis revealed that a nonmyeloablative regimen (P = .009; hazard ratio [HR], 4.05), infused CD34-positive cell dosage (P = .01; HR, 3.32), and high HARI (P = .02; HR, 2.82) were independent predictors. However, a high HARI did not correlate with nonrelapsed mortality and overall survival. In conclusion, it seems that a high HARI before SCT might be an important predictor of significant hepatic GvHD in patients after allogeneic SCT.
肝动脉阻力指数（HARI）可反映多种肝脏疾病中的门静脉血压和阻力。本研究调查了预处理的HARI值是否能预测异基因干细胞移植（SCT）后诸如肝移植物抗宿主病（GvHD）、静脉闭塞性疾病以及药物和脓毒症相关肝毒性等肝脏并发症。对59例行异基因SCT的患者进行研究，以确定SCT前的HARI是否能预测SCT后的肝脏并发症。26例患者（44.1%）在异基因SCT前HARI值较高（≥0.74）。单因素分析显示，高HARI值与肝GvHD的发生率相关。多因素分析表明，非清髓方案（P = 0.009；风险比[HR]，4.05）、输注的CD34阳性细胞剂量（P = 0.01；HR，3.32）和高HARI（P = 0.02；HR，2.82）是独立的预测因素。然而，高HARI与非复发死亡率和总生存率无关。总之，SCT前高HARI似乎可能是异基因SCT后患者发生严重肝GvHD的重要预测因素。
