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肝移植早期移植物功能衰竭的危险因素及预测指标

Risk factors and predictive indexes of early graft failure in liver transplantation.

作者信息

Marino I R, Starzl T E, Aldrighetti L, Doria C, Morelli F, Gayowski T J, Madariaga J R, Doyle H R

机构信息

Pittsburgh Transplantation Institute, University of Pittsburgh Medical Center, PA, USA.

出版信息

Ital J Gastroenterol. 1996 Apr;28(3):163-8.

PMID:8789828
Abstract

A retrospective analysis of 462 consecutive liver transplantations has been carried out. These were divided into two groups, according to whether they failed within 90 days (Group I) or survived longer than 90 days (Group II). Twenty-five donor and recipient variables were analyzed. In the univariate analysis, the only donor variable that was significantly different between the two groups was age (45.3 +/- 16.9 years in Group I vs 37.9 +/- 15.4 years in Group II, p < 0.001). There were five recipient variables significantly associated with early graft failure: history of previous liver transplantations (p < 0.0001), United Network for Organ Sharing 4 status (p = 0.003), primary diagnosis (p = 0.001), preoperative serum creatinine (1.97 +/- 1.5 mg/dL in Group I vs 1.46 +/- 1.2 mg/dL in Group II, p = 0.005), and preoperative total serum bilirubin (13.5 +/- 14.4 mg/dL in Group I vs 8.4 +/- 11.4 mg/dL in Group II, p = 0.003). In the multivariate analysis, only three variables were independently associated with outcome: donor age greater than 45 years, abnormal (> 1.5 mg/dL) recipient preoperative creatinine, and a history of previous liver transplantation.

摘要

对连续462例肝移植进行了回顾性分析。根据移植后90天内是否失败(第一组)或存活超过90天(第二组)将这些病例分为两组。分析了25个供体和受体变量。在单因素分析中,两组之间唯一有显著差异的供体变量是年龄(第一组为45.3±16.9岁,第二组为37.9±15.4岁,p<0.001)。有五个受体变量与早期移植失败显著相关:既往肝移植史(p<0.0001)、器官共享联合网络4级状态(p = 0.003)、主要诊断(p = 0.001)、术前血清肌酐(第一组为1.97±1.5mg/dL,第二组为1.46±1.2mg/dL,p = 0.005)以及术前总血清胆红素(第一组为13.5±14.4mg/dL,第二组为8.4±11.4mg/dL,p = 0.003)。在多因素分析中,只有三个变量与结果独立相关:供体年龄大于45岁、受体术前肌酐异常(>1.5mg/dL)以及既往肝移植史。

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