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细胞死亡生物标志物作为肝移植术后肝功能障碍的早期预测指标。

Cell death biomarkers as early predictors for hepatic dysfunction in patients after orthotopic liver transplantation.

机构信息

Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany.

出版信息

Transplantation. 2012 Jul 27;94(2):185-91. doi: 10.1097/TP.0b013e318254397c.

Abstract

BACKGROUND

Valid prognostic factors for early identification of a complicated course after orthotopic liver transplantation from deceased donors are rare. The aim of this study was to investigate the prognostic value of different cell death biomarkers and inflammatory markers in patients after orthotopic liver transplantation from deceased donors.

METHODS

In total, 100 patients were evaluated for short-term complications within 10 days after orthotopic liver transplantation from deceased donors. Blood samples were collected before surgery, immediately after the end of the surgical procedure, and 1 day and 3, 5, and 7 days later. Plasma levels of total keratin 18, keratin 18 fragments, interleukin 6, tumor necrosis factor α, and soluble intercellular adhesion molecule 1 were measured.

RESULTS

Total keratin 18 was demonstrated to be favorable in its prognostic value for early identification of a complicated course in comparison to routine markers of liver impairment (e.g., aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase). In contrast, inflammation markers (e.g., interleukin 6, tumor necrosis factor α and soluble intercellular adhesion molecule 1) were unsuitable for predicting early complications after liver transplantation from deceased donors.

CONCLUSIONS

For early identification of patients at high risk for complications, the implementation of total keratin 18 measurements in routine diagnostics after orthotopic liver transplantation from deceased donors should be taken into consideration.

摘要

背景

对于从已故供体进行原位肝移植后早期识别复杂病程的有效预后因素很少见。本研究的目的是探讨不同细胞死亡生物标志物和炎症标志物在从已故供体进行原位肝移植后的患者中的预后价值。

方法

总共评估了 100 例从已故供体进行原位肝移植后 10 天内发生短期并发症的患者。在手术前、手术结束后立即以及第 1 天、第 3 天、第 5 天和第 7 天采集血样。测量血浆总角蛋白 18、角蛋白 18 片段、白细胞介素 6、肿瘤坏死因子α和可溶性细胞间黏附分子 1 的水平。

结果

与肝功能损害的常规标志物(如天冬氨酸氨基转移酶、丙氨酸氨基转移酶、乳酸脱氢酶)相比,总角蛋白 18 显示出有利于早期识别复杂病程的预后价值。相比之下,炎症标志物(如白细胞介素 6、肿瘤坏死因子α和可溶性细胞间黏附分子 1)不适合预测从已故供体进行肝移植后的早期并发症。

结论

为了早期识别高并发症风险的患者,应考虑在从已故供体进行原位肝移植后常规诊断中实施总角蛋白 18 测量。

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