Canbaz Hayri, Bestemir Attila, Akbulut Sami, Yilmaz Sezai, Yavuz Yusuf
Department of Emergency Medicine, Yildirim Beyazit University, Yenimahalle Training and Research Hospital, Ankara, Türkiye.
Department of Private Health Institutions with Outpatient Diagnosis and Treatment, Ministry of Health, Ankara, Türkiye.
Turk J Gastroenterol. 2024 Nov 4;36(2):107-113. doi: 10.5152/tjg.2024.24226.
BACKGROUND/AIMS: Liver transplantation is a life-saving approach in some cases of mushroom poisoning, which is one of the important causes of acute liver failure. However, debate continues regarding the timing of liver transplantation. The aim of this study is to retrospectively evaluate the results of patients who underwent liver transplantation due to mushroom poisoning.
In this descriptive and observational study, the demographic and clinical data of 26 patients who presented to emergency units due to clinical features of acute hepatic failure secondary to mushroom poisoning between October 2008 and November 2023 and who underwent emergent liver transplantation were retrospectively reviewed.
A total of 26 patients with a median (IQR) age of 39 (36) years were included in this study. The patients were divided into two groups: alive (n = 18) and dead (n = 8). No statistically significant differences were found between groups in terms of age, BMI, blood groups, hepatic encephalopathy grade, biochemical analysis obtained on the first days of hospital admission (AST, ALT, creatinine, ammonia, PTT, INR, albumin, platelets, HGB), ICU stay, cold ischemia time (CIT) and warm ischemia time (WIT), total bilirubin (P = .052), and time from poisoning to admission (P = .051). On the other hand, there were statistically significant differences between the alive and dead groups in terms of MELD score (P = .016; 23 vs. 34), re-transplantation (P = .022; 0% vs. 37.5%), hospital stay (P = .004; 24 vs. 6 days), and follow up (P < .001; 3423 vs. 5 days).
This study showed that mortality was higher in patients with high MELD scores and patients who underwent re-transplantation. However, this study needs to be supported by multicenter prospective studies.
背景/目的：肝移植是某些蘑菇中毒病例的一种挽救生命的方法，蘑菇中毒是急性肝衰竭的重要原因之一。然而，关于肝移植的时机仍存在争议。本研究的目的是回顾性评估因蘑菇中毒接受肝移植患者的结果。
在这项描述性观察研究中，回顾性分析了2008年10月至2023年11月间因蘑菇中毒继发急性肝衰竭的临床特征而就诊于急诊科并接受急诊肝移植的26例患者的人口统计学和临床数据。
本研究共纳入26例患者，中位（四分位间距）年龄为39（36）岁。患者分为两组：存活组（n = 18）和死亡组（n = 8）。两组在年龄、体重指数、血型、肝性脑病分级、入院首日的生化分析指标（谷草转氨酶、谷丙转氨酶、肌酐、氨、活化部分凝血活酶时间、国际标准化比值、白蛋白、血小板、血红蛋白）、重症监护病房停留时间、冷缺血时间和热缺血时间、总胆红素（P = 0.052）以及中毒至入院时间（P = 0.051）方面均未发现统计学显著差异。另一方面，存活组和死亡组在终末期肝病模型（MELD）评分（P = 0.016；23对34）、再次移植（P = 0.022；0%对37.5%）、住院时间（P = 0.004；24对6天）和随访时间（P < 0.001；3423对5天）方面存在统计学显著差异。
本研究表明，MELD评分高的患者和接受再次移植的患者死亡率较高。然而，本研究需要多中心前瞻性研究的支持。
