Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road Suzhou, Jiangsu, China.
Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
BMC Gastroenterol. 2023 Jul 13;23(1):237. doi: 10.1186/s12876-023-02744-0.
Parental liver transplantation (PLT) improves long-term survival rates in paediatric hepatic failure patients; however, the mechanism of PLT-induced postoperative pulmonary complications (PPCs) is unclear.
A total of 133 paediatric patients undergoing PLT were included. Serum levels of NET components, including circulating free DNA (cfDNA), DNA-histone complex, and myeloperoxidase (MPO)-DNA complex, were detected. The occurrence of PPCs post-PLT, prolonged intensive care unit (ICU) stay and death within one year were recorded as the primary and secondary outcomes.
The overall rate of PPCs in the hospital was 47.4%. High levels of serum cfDNA, DNA-histone complexes and MPO-DNA complexes were associated with an increased risk of PPCs (for cfDNA, OR 2.24; for DNA-histone complex, OR 1.64; and for MPO-DNA, OR 1.94), prolonged ICU stay (OR 1.98, 4.26 and 3.69, respectively), and death within one year (OR 1.53, 2.65 and 1.85, respectively). The area under the curve of NET components for the prediction of PPCs was 0.843 for cfDNA, 0.813 for DNA-histone complexes, and 0.906 for MPO-DNA complexes. During the one-year follow-up, the death rate was higher in patients with PPCs than in patients without PPCs (14.3% vs. 2.9%, P = 0.001).
High serum levels of NET components are associated with an increased incidence of PPCs and death within one year in paediatric patients undergoing PLT. Serum levels of NET components serve as a biomarker for post-PLT PPCs and a prognostic indicator.
亲体肝移植（PLT）可提高小儿肝衰竭患者的长期生存率；然而，PLT 术后引发肺部并发症（PPCs）的机制尚不清楚。
共纳入 133 例行 PLT 的小儿患者。检测 NET 成分（包括循环游离 DNA（cfDNA）、DNA-组蛋白复合物和髓过氧化物酶（MPO）-DNA 复合物）的血清水平。记录 PLT 术后 PPCs 的发生、延长的重症监护病房（ICU）停留时间和 1 年内死亡作为主要和次要结局。
医院内 PPCs 的总发生率为 47.4%。高水平的血清 cfDNA、DNA-组蛋白复合物和 MPO-DNA 复合物与 PPCs（cfDNA 的 OR 2.24；DNA-组蛋白复合物的 OR 1.64；MPO-DNA 的 OR 1.94）、延长的 ICU 停留时间（OR 1.98、4.26 和 3.69）和 1 年内死亡（OR 1.53、2.65 和 1.85）的风险增加相关。NET 成分预测 PPCs 的曲线下面积为 cfDNA 0.843、DNA-组蛋白复合物 0.813 和 MPO-DNA 复合物 0.906。在 1 年的随访期间，PPCs 患者的死亡率高于无 PPCs 患者（14.3% vs. 2.9%，P=0.001）。
高水平的血清 NET 成分与小儿 PLT 后 PPCs 的发生率增加和 1 年内死亡相关。NET 成分的血清水平可作为 PLT 后 PPCs 的生物标志物和预后指标。
