抗凝血酶 III 在活体肝移植中急性肾损伤的预测效用：一项回顾性观察性队列研究。

Predictive Utility of Antithrombin III in Acute Kidney Injury in Living-Donor Liver Transplantation: A Retrospective Observational Cohort Study.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Incheon St. Marys Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Transplant Proc. 2021 Jan-Feb;53(1):111-118. doi: 10.1016/j.transproceed.2020.10.005. Epub 2020 Dec 4.

DOI:10.1016/j.transproceed.2020.10.005

PMID:33272652

Abstract

INTRODUCTION

This study was performed to determine the association between the serum level of antithrombin III (ATIII) level and the risk of acute kidney injury (AKI) in patients undergoing living-donor liver transplantation (LDLT).

PATIENTS AND METHODS

A total of 591 patients undergoing LDLT were retrospectively investigated and 14 patients were excluded because of a history of kidney dysfunction or missing data; 577 patients were finally enrolled in the study. The study population was divided into normal and low ATIII groups. Data on all laboratory variables, including ATIII, were collected on the day before surgery.

RESULTS

After LDLT, 143 patients developed AKI (24.8%). A lower ATIII was independently associated with postoperative AKI along with preoperative (diabetes mellitus) and intraoperative (mean heart rate, hourly urine output) factors. Based on the standard cutoff for normal ATIII (<70%), the probability of AKI was 2.8-fold higher in the low ATIII group than in the normal ATIII group. In addition, patients with low ATIII received blood transfusion products during the operation and underwent longer duration mechanical ventilation.

CONCLUSIONS

Preoperative ATIII measurement will help improve risk stratification for postoperative AKI development in patients undergoing LDLT.

摘要

简介

本研究旨在探讨接受活体肝移植（LDLT）的患者血清抗凝血酶 III（ATIII）水平与急性肾损伤（AKI）风险之间的关系。

患者与方法

回顾性调查了 591 名接受 LDLT 的患者，其中 14 名患者因肾功能障碍病史或缺失数据被排除在外；最终纳入 577 名患者进行研究。将研究人群分为正常 ATIII 组和低 ATIII 组。术前一天收集所有实验室变量（包括 ATIII）的数据。

结果

LDLT 后，143 名患者发生 AKI（24.8%）。较低的 ATIII 与术后 AKI 以及术前（糖尿病）和术中（平均心率、每小时尿量）因素独立相关。根据正常 ATIII 的标准截断值（<70%），低 ATIII 组 AKI 的概率是正常 ATIII 组的 2.8 倍。此外，低 ATIII 患者在手术中接受了输血制品，并接受了更长时间的机械通气。