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原发性肝移植功能障碍与无功能:综合文献综述

Primary liver graft dysfunction and non-function: integrative literature review.

作者信息

Salviano Márcia Eller Miranda, Lima Agnaldo Soares, Tonelli Isadora Soto, Correa Hérica Pinheiro, Chianca Tânia Couto Machado

机构信息

Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brasil.

Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Cirurgia, Belo Horizonte, MG, Brasil.

出版信息

Rev Col Bras Cir. 2019;46(1):e2039. doi: 10.1590/0100-6991e-20192039. Epub 2019 Apr 18.

Abstract

Avoiding deaths in the waiting list for an organ is no longer the only focus of the transplant teams attention. Research and care in clinical practice has been increasingly focused on post transplant graft survival and functioning. In the present work, we performed an integrative literature review to identify the terminology used about liver graft dysfunction and non-function, as well as to investigate the incidence and risk factors of these clinical events. We chosen articles written in Portuguese, English and Spanish between 2012 and 2016, based on CINAHL, MEDLINE, Cochrane, LILACS, BDENF, IBECS, EMBASE and Web of Science. We selected 14 studies, in which we identified the incidence of hepatic graft dysfunction ranging from 7% to 27%. The terminology used to describe this clinical event was initial malfunction, graft hypofunction, marginal function or delay in function. The primary non-function of the liver graft was found in 1.4% to 8.4% of the patients, and the terminology used to describe the event was early dysfunction or graft loss. The risk factors found are related to donor, recipient, graft and transplant logistics variables. We conclude that knowledge of the different terminologies employed in the literature, related to dysfunction and primary non- function incidence, and of their risk factors are fundamental to qualify the control of the events, aiming to improve patients' survival after liver transplantation.

摘要

避免器官等待名单上的死亡已不再是移植团队关注的唯一焦点。临床实践中的研究与护理越来越关注移植后移植物的存活和功能。在本研究中,我们进行了一项综合性文献综述,以确定有关肝移植功能障碍和无功能的术语,并调查这些临床事件的发生率和危险因素。我们基于CINAHL、MEDLINE、Cochrane、LILACS、BDENF、IBECS、EMBASE和科学网,选取了2012年至2016年间用葡萄牙语、英语和西班牙语撰写的文章。我们选择了14项研究,其中我们确定肝移植功能障碍的发生率在7%至27%之间。用于描述这一临床事件的术语有初始功能障碍、移植物功能减退、边缘功能或功能延迟。肝移植原发性无功能在1.4%至8.4%的患者中被发现,用于描述该事件的术语有早期功能障碍或移植物丢失。发现的危险因素与供体、受体、移植物和移植后勤变量有关。我们得出结论,了解文献中使用的与功能障碍和原发性无功能发生率及其危险因素相关的不同术语,对于规范这些事件的控制至关重要,旨在提高肝移植患者的生存率。

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