Zhang Qun, Guo Renyong, Chen Yu
Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Laboratory Medicine, Tonglu First People's Hospital, Hangzhou, China.
J Clin Lab Anal. 2019 Jan;33(1):e22646. doi: 10.1002/jcla.22646. Epub 2018 Aug 13.
This study aimed to investigate the relationship between plasma D-dimer level, preoperative complications, and thrombosis in liver transplant recipients.
The clinical data of 525 liver transplant recipients with end-stage liver disease (ESLD) in the First Affiliated Hospital of Zhejiang University from October 2012 to December 2015 were retrospectively analyzed. The patients were grouped based on thrombosis before and after surgery to determine the risk factors for postoperative thrombosis recurrence.
Of the preoperative complications assessed, esophageal varices and thrombosis were significantly correlated (P = 0.000); ascites, spontaneous bacterial peritonitis, and hepatic encephalopathy were significantly correlated with preoperative D-dimer level (P < 0.001, P < 0.001, and P = 0.002, respectively); during the first week after surgery, the D-dimer level was significantly and consecutively higher than that before surgery and was significantly higher in the group with both preoperative and postoperative thrombosis than in the other groups on the first day after surgery (P < 0.001); the area under the curve (AUC) for diagnosis of postoperative thrombosis recurrence in the preoperative thrombosis group using plasma D-dimer level on the first day after surgery was 0.698 (P = 0.001); Cox regression analysis showed that D-dimer was an independent risk factor for postoperative thrombosis recurrence (HR = 3.062, P = 0.029).
D-dimer level on the first day after liver transplant is related to thrombosis recurrence and is an independent risk factor for postoperative thrombosis recurrence.
本研究旨在探讨肝移植受者血浆D - 二聚体水平、术前并发症与血栓形成之间的关系。
回顾性分析2012年10月至2015年12月浙江大学医学院附属第一医院525例终末期肝病(ESLD)肝移植受者的临床资料。根据手术前后是否发生血栓对患者进行患者进行分组,以确定术后血栓复发的危险因素。
在所评估的术前并发症中,食管静脉曲张与血栓形成显著相关(P = 0.000);腹水、自发性细菌性腹膜炎和肝性脑病与术前D - 二聚体水平显著相关(分别为P < 0.001、P < 0.001和P = 0.002);术后第一周,D - 二聚体水平显著且持续高于术前,术前和术后均有血栓形成的组在术后第一天的D - 二聚体水平显著高于其他组(P < 0.001);术后第一天使用血浆D - 二聚体水平诊断术前有血栓形成组术后血栓复发的曲线下面积(AUC)为0.698(P = 0.001);Cox回归分析显示,D - 二聚体是术后血栓复发的独立危险因素(HR = 3.062,P = 0.029)。
肝移植术后第一天的D - 二聚体水平与血栓复发有关,是术后血栓复发的独立危险因素。