肝移植受者肝性脑病的长期预后

Long-term Outcomes for Liver Transplant Recipients in Terms of Hepatic Encephalopathy.

作者信息

You D D, Choi G S, Kim J M, Kwon C H D, Joh J-W, Lee S-K

机构信息

Department of Surgery, The Catholic University of Korea St. Vincent's Hospital, Suwon, Korea.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.

出版信息

Transplant Proc. 2017 Jul-Aug;49(6):1425-1429. doi: 10.1016/j.transproceed.2017.02.054.

DOI:10.1016/j.transproceed.2017.02.054

PMID:28736017

Abstract

BACKGROUND

Liver transplantation (LT) is thought to resolve cognitive deficit due to hepatic encephalopathy (HE). The aim of this study was to determine the factors associated with the outcomes of patients with HE after LT.

METHODS

The authors reviewed the medical records of 388 patients with HE who underwent LT from 1996 to 2014.

RESULTS

There were 282 patients with grade 1-2 HE and 106 patients classified as grade 3-4. Patients in the latter group had a tendency for a more decompensated hepatic condition than patients with grade 1-2 HE. HE sequelae were only associated with grade 3-4 HE with borderline significance (P = .05). The cumulative 1-, 3-, and 5-year overall survival (OS) of patients with grade 1-2 HE were 81.9%, 77.3%, and 74.6%, whereas those of in patients with grade 3-4 HE were 77.4%, 73.3%, and 72.2%, respectively (P = .75).

CONCLUSION

The sequelae of HE were only associated with the grade 3-4 HE. Aggressive treatment of HE prior to LT may prevent patients from deteriorating into high-grade HE, which could further contribute to improving the outcomes after LT.

摘要

背景

肝移植（LT）被认为可解决因肝性脑病（HE）导致的认知缺陷。本研究的目的是确定肝移植后肝性脑病患者预后的相关因素。

方法

作者回顾了1996年至2014年接受肝移植的388例肝性脑病患者的病历。

结果

有282例1-2级肝性脑病患者和106例被归类为3-4级的患者。后一组患者的肝脏失代偿情况比1-2级肝性脑病患者更严重。肝性脑病后遗症仅与3-4级肝性脑病相关，具有临界显著性（P = 0.05）。1-2级肝性脑病患者的1年、3年和5年累积总生存率（OS）分别为81.9%、77.3%和74.6%，而3-4级肝性脑病患者的累积总生存率分别为77.4%、73.3%和72.2%（P = 0.75）。