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术前慢性肾衰竭对肝移植的影响:一项基于人群的队列研究。

Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study.

作者信息

Chung Peter Chi-Ho, Chen Hsiu-Pin, Lin Jr-Rung, Liu Fu-Chao, Yu Huang-Ping

机构信息

Department of Anesthesiology, Chang Gung Memorial Hospital; College of Medicine.

Clinical Informatics and Medical Statistics Research Center; Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Ther Clin Risk Manag. 2016 Dec 14;12:1855-1860. doi: 10.2147/TCRM.S123011. eCollection 2016.

DOI:10.2147/TCRM.S123011
PMID:28008264
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5167298/
Abstract

PURPOSE

The purpose of this study was to assess whether preoperative chronic renal failure (CRF) affects the rates of postoperative complications and survival after liver transplantation.

METHODS

This population-based retrospective cohort study included 2,931 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. Patients were divided into two groups, based on the presence or absence of preoperative CRF.

RESULTS

The overall estimated survival rate of liver transplantation recipients (LTRs) with preoperative CRF was significantly lower than that of patients without preoperative CRF (=0.0085). There was no significant difference between the groups in terms of duration of intensive care unit stay, total hospital stay, bacteremia, postoperative bleeding, and pneumonia during hospitalization. Long-term adverse effects, including cerebrovascular disease and coronary heart disease, were not different between patients with versus without CRF.

CONCLUSION

These findings suggest that LTRs with preoperative CRF have a higher rate of mortality.

摘要

目的

本研究旨在评估术前慢性肾衰竭(CRF)是否会影响肝移植术后的并发症发生率及生存率。

方法

这项基于人群的回顾性队列研究纳入了1998年至2012年间在台湾国民健康保险研究数据库登记的2931例肝移植受者。根据术前是否存在CRF将患者分为两组。

结果

术前患有CRF的肝移植受者(LTRs)的总体估计生存率显著低于术前未患CRF的患者(P = 0.0085)。两组在重症监护病房住院时间、总住院时间、菌血症、术后出血及住院期间肺炎方面无显著差异。包括脑血管疾病和冠心病在内的长期不良反应在有CRF和无CRF的患者之间并无差异。

结论

这些发现表明,术前患有CRF的LTRs死亡率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/ce482ba53909/tcrm-12-1855Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/00db7c1ec676/tcrm-12-1855Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/ae0b7a7d9a3f/tcrm-12-1855Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/ce482ba53909/tcrm-12-1855Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/00db7c1ec676/tcrm-12-1855Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/ae0b7a7d9a3f/tcrm-12-1855Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d4/5167298/ce482ba53909/tcrm-12-1855Fig3.jpg

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本文引用的文献

1
Current Treatment Approaches to HCC with a Special Consideration to Transplantation.肝癌的当前治疗方法,特别考虑移植因素
J Transplant. 2016;2016:7926264. doi: 10.1155/2016/7926264. Epub 2016 Jun 20.
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Selection Criteria and Current Issues in Liver Transplantation for Hepatocellular Carcinoma.肝细胞癌肝移植的选择标准与当前问题
Liver Cancer. 2016 Apr;5(2):121-7. doi: 10.1159/000367749. Epub 2016 Mar 17.
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Acute Kidney Disease After Liver and Heart Transplantation.肝移植和心脏移植后的急性肾损伤
Transplantation. 2016 Mar;100(3):506-14. doi: 10.1097/TP.0000000000000916.
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[Early detection, prevention and management of renal failure in liver transplantation].肝移植中肾衰竭的早期检测、预防及管理
Gastroenterol Hepatol. 2014 Oct;37(8):480-91. doi: 10.1016/j.gastrohep.2013.11.006. Epub 2014 Jul 22.
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[Kidney function and liver transplantation].[肾功能与肝移植]
Orv Hetil. 2013 Jun 30;154(26):1018-25. doi: 10.1556/OH.2013.29641.
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Kidney disease and increased mortality risk in type 2 diabetes.2 型糖尿病与肾脏疾病和死亡率升高有关。
J Am Soc Nephrol. 2013 Feb;24(2):302-8. doi: 10.1681/ASN.2012070718. Epub 2013 Jan 29.
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Impact of insurance and hospital ownership on hospital length of stay among patients with ambulatory care-sensitive conditions.保险和医院所有权对门诊护理敏感状况患者住院时间的影响。
Ann Fam Med. 2011 Nov-Dec;9(6):489-95. doi: 10.1370/afm.1315.
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Acute renal dysfunction in patients with alcoholic hepatitis.酒精性肝炎患者的急性肾功能障碍
World J Hepatol. 2011 May 27;3(5):121-4. doi: 10.4254/wjh.v3.i5.121.
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Acute kidney injury after procedures of orthotopic liver transplantation.原位肝移植术后急性肾损伤
Ann Transplant. 2011 Apr-Jun;16(2):103-8. doi: 10.12659/aot.881872.
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Management of renal dysfunction in the liver transplant recipient.肝移植受者肾功能障碍的管理
Curr Opin Organ Transplant. 2009 Jun;14(3):231-9. doi: 10.1097/MOT.0b013e32832b34a4.