Wang Wenjing, Zhao Qiang, Hu Anbin, He Xiaoshun, Zhu Xiaofeng
Organ Transplantation Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland).
Ann Transplant. 2017 Apr 11;22:208-214. doi: 10.12659/aot.901277.
BACKGROUND The relationship between the clearance rate of ICG (indocyanine green) and varying degrees of liver fatty degeneration remains to be explored. The value of ICG detection in the evaluation of early prognosis following hepatic transplantation has been rarely investigated. MATERIAL AND METHODS Clinical data of 106 patients undergoing liver transplantation were retrospectively analyzed. The severity of fatty degeneration of the resected liver specimens was assessed by pathological biopsy. All patients were assigned into one of three groups: A (no fatty degeneration), B (<20% hepatic fatty degeneration) or C (20-40% hepatic fatty degeneration). Multiple parameters were statistically compared among the three groups before, during, and after liver transplantation. RESULTS The results demonstrated that R15-D (15 minute detection rate of ICG in the donors) was positively correlated with R15-R (15 minute detection rate of ICG in the recipients). After liver transplantation, the peak values of ALT and total bilirubin (TB), and the R15-R and the rate of early allograft dysfunction (EAD) in group C were the highest among all three groups. However, the 3-month and 6-month survival rate of the grafts and the 1-year survival rate of the patients in group A were considerably lower compared to groups B and C. The area under the curve (AUC) of R15-R in predicting the EAD, 3-month survival rate and 6-month survival rate of the grafts and the 1-year survival rate of the patients was 0.956, 0.827, 0.867, and 0.794, respectively. CONCLUSIONS ICG detection rate can be used to predict the early prognosis of patients diagnosed with moderate liver fatty degeneration.
背景 吲哚菁绿(ICG)清除率与不同程度的肝脏脂肪变性之间的关系仍有待探索。ICG检测在肝移植术后早期预后评估中的价值鲜有研究。
材料与方法 回顾性分析106例肝移植患者的临床资料。通过病理活检评估切除肝脏标本的脂肪变性严重程度。所有患者被分为三组之一:A组(无脂肪变性)、B组(肝脏脂肪变性<20%)或C组(肝脏脂肪变性20%-40%)。对三组患者肝移植术前、术中及术后的多个参数进行统计学比较。
结果 结果表明,R15-D(供体ICG 15分钟检测率)与R15-R(受体ICG 15分钟检测率)呈正相关。肝移植后,C组的ALT和总胆红素(TB)峰值、R15-R以及早期移植物功能障碍(EAD)发生率在三组中最高。然而,与B组和C组相比,A组移植物的3个月和6个月生存率以及患者的1年生存率显著较低。R15-R预测移植物EAD、3个月生存率、6个月生存率以及患者1年生存率的曲线下面积(AUC)分别为0.956、0.827、0.867和0.794。
结论 ICG检测率可用于预测中度肝脏脂肪变性患者的早期预后。