脾脏瞬时弹性成像可预测肝移植后的实际生存率。
Spleen transient elastography predicts actuarial survival after liver transplantation.
作者信息
Friedrich Kilian, Mehrabi Arianeb, Pfeiffenberger Jan, Rupp Christian, Weiss Karl Heinz, Mieth Markus
机构信息
Department of Gastroenterology and Hepatology, University Hospital of Heidelberg, Heidelberg, Germany.
Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany.
出版信息
Transl Gastroenterol Hepatol. 2022 Jul 25;7:31. doi: 10.21037/tgh-19-343. eCollection 2022.
BACKGROUND
Splenic transient elastography (TE) correlates with increased portal pressure. Little data are available in the post liver transplantation (LTx) setting.
METHODS
Three months after LTx, we performed splenic TE in 125 LTx recipients.
RESULTS
Mean splenic TE values were 29.4 (±6.3; range, 21.6-49.2) kPa. Splenic TE correlated with reduced time to development until persistent ascites (30 events, OR =1.082, 95% CI: 1.034-1.133; P=0.001), hepatorenal syndrome (8 events, OR =1.109, 95% CI: 1.015-1.211; P=0.022) and hepatic encephalopathy (16 events, OR =1.136, 95% CI: 1.066-1.211; P=0.000). In Cox univariate analysis, splenic TE served as a predictor of actuarial survival free of liver (OR =1.114, 95% CI: 1.050-1.182; P<0.001) and remained an independent risk factor associated with reduced actuarial survival free of LTx in multivariate analysis (OR =1.103, 95% CI: 1.026-1.186; P=0.008).
CONCLUSIONS
Splenic TE measurement at 3 months after LTx serves as a robust predictor of survival in LTx recipients.
背景
脾脏瞬时弹性成像（TE）与门静脉压力升高相关。在肝移植（LTx）后情况下的数据较少。
方法
肝移植后三个月，我们对125例肝移植受者进行了脾脏TE检查。
结果
脾脏TE的平均数值为29.4（±6.3；范围，21.6 - 49.2）kPa。脾脏TE与直至出现持续性腹水（30例事件，OR = 1.082，95%CI：1.034 - 1.133；P = 0.001）、肝肾综合征（8例事件，OR = 1.109，95%CI：1.015 - 1.211；P = 0.022）和肝性脑病（16例事件，OR = 1.136，95%CI：1.066 - 1.211；P = 0.000）的发生时间缩短相关。在Cox单因素分析中，脾脏TE可作为无肝生存期精算生存率的预测指标（OR = 1.114，95%CI：1.050 - 1.182；P < 0.001），并且在多因素分析中仍是与肝移植后无肝精算生存率降低相关的独立危险因素（OR = 1.103，95%CI：1.026 - 1.186；P = 0.008）。
结论
肝移植后三个月测量脾脏TE可作为肝移植受者生存的有力预测指标。
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