Ricci P, Therneau T M, Malinchoc M, Benson J T, Petz J L, Klintmalm G B, Crippin J S, Wiesner R H, Steers J L, Rakela J, Starzl T E, Dickson E R
Baylor University Medical Center, Dallas, TX, USA.
Hepatology. 1997 Mar;25(3):672-7. doi: 10.1002/hep.510250330.
We studied the outcome of 436 patients with primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC) who underwent orthotopic liver transplant (OLT) at three major liver transplant centers. Univariate predictors of outcome included age, Karnofsky score, Child's class, Mayo risk score, United Network for Organ Sharing (UNOS) status, nutritional status, serum albumin, serum bilirubin, international normalized ratio, and the presence of ascites, encephalopathy, renal failure (serum creatinine > 2 mg/dL), and edema refractory to diuretics. Using these predictors, we developed a four variable mathematical prognostic model to help the liver transplant physician predict the following: 1) the amount of intraoperative blood loss; 2) the number of days in the intensive care unit (ICU); and 3) severe complications after surgery. The model uses age, renal failure, Child's class, and United Network for Organ Sharing status. This study is the first to model the outcome of liver transplant in patients with a specific etiology of chronic liver disease (PBC or PSC). The model may be used to help select patients for OLT and to plan the timing of their transplantation.
我们研究了436例原发性胆汁性肝硬化（PBC）或原发性硬化性胆管炎（PSC）患者的预后情况，这些患者在三个主要肝脏移植中心接受了原位肝移植（OLT）。预后的单因素预测指标包括年龄、卡诺夫斯基评分、Child分级、梅奥风险评分、器官共享联合网络（UNOS）状态、营养状况、血清白蛋白、血清胆红素、国际标准化比值，以及腹水、肝性脑病、肾衰竭（血清肌酐>2mg/dL）和利尿剂难治性水肿的存在情况。利用这些预测指标，我们建立了一个四变量数学预后模型，以帮助肝脏移植医生预测以下内容：1）术中失血量；2）重症监护病房（ICU）的住院天数；3）术后严重并发症。该模型使用年龄、肾衰竭、Child分级和器官共享联合网络状态。本研究首次对患有特定慢性肝病病因（PBC或PSC）的患者肝移植预后进行建模。该模型可用于帮助选择OLT患者并规划其移植时机。
