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原位肝移植术后再灌注综合征的危险因素:一项临床观察性研究。

Risk factors of the post-reperfusion syndrome during orthotopic liver transplantation: a clinical observational study.

机构信息

Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

BMC Anesthesiol. 2022 Apr 2;22(1):89. doi: 10.1186/s12871-022-01635-3.

Abstract

BACKGROUND

Post reperfusion syndrome (PRS) is a relatively common and life-threatening complication during orthotopic liver transplantation (OLT). It is associated with poor patient and transplanted liver outcomes.

OBJECTIVE

This study aimed to compare the risk factors of PRS during OLT.

DESIGN

Clinical-epidemiological observational retrospective study.

SETTING

We gathered the records of patients who underwent OLT in 3 years, from May 22, 2016, to May 22, 2019, in Namazi and Bu-Ali Sina organ transplantation hospitals.

PATIENTS

In this study, we assessed 1182 patients who underwent OLT. Patients were divided into two groups based on the presence or absence of PRS.

MAIN OUTCOME MEASURES

Diagnosing the predictors of PRS was the primary outcome of this study.

RESULTS

Results showed that age > 60 years, Child-Pugh scores C, higher Model End Stage liver disease score, and preoperative sodium < 130 mmol/l (parameters of the liver recipient), increase in cold ischemic time (the donors' parameters), and the classical technique (the surgical parameters) were the strong predictors of PRS.

CONCLUSIONS

The results indicated that underlying liver disease was not the predictor of PRS in the presence of other risk factors; therefore, clinicians have to consider these risk factors in patients undergoing OLT.

摘要

背景

再灌注后综合征(PRS)是原位肝移植(OLT)过程中相对常见且危及生命的并发症。它与患者和移植肝预后不良有关。

目的

本研究旨在比较 OLT 过程中 PRS 的危险因素。

设计

临床流行病学观察性回顾性研究。

地点

我们收集了 2016 年 5 月 22 日至 2019 年 5 月 22 日在纳马齐和布阿里·西纳器官移植医院接受 OLT 的患者的记录。

患者

在这项研究中,我们评估了 1182 名接受 OLT 的患者。患者根据是否存在 PRS 分为两组。

主要观察指标

诊断 PRS 的预测因素是本研究的主要结果。

结果

结果表明,年龄>60 岁、Child-Pugh 评分 C、较高的终末期肝病模型评分、术前血清钠<130mmol/L(受者肝脏参数)、冷缺血时间增加(供者参数)和经典技术(手术参数)是 PRS 的强烈预测因素。

结论

结果表明,在存在其他危险因素的情况下,潜在的肝脏疾病不是 PRS 的预测因素;因此,临床医生必须在接受 OLT 的患者中考虑这些危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc80/8976299/acd06e3ac088/12871_2022_1635_Fig1_HTML.jpg

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