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Preoperative risk factor analysis in orthotopic liver transplantation with pretransplant artificial liver support therapy

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World Journal of Gastroenterology 2006年第31期12卷 5055-5059页

作者： Jin-Zhong Yuan Qi-Fa Ye Ling-Ling Zhao Ying-Zi Ming Hong Sun Shai-Hong Zhu Zu-Fa Huang Min-Min Wang Blood Purification Center Xiangya Transplantation Institute Third Xiangya Hospital of Central South University Changsha 410013 Hunan Province China

AIM： To assess the value of pre-transplant artificial liver support in reducing the pre-operative risk factors relating to early mortality after orthotopic liver transplantation （OLT）. METHODS： Fifty adult patients with various stages and various etiologies undergoing OLT procedures were treated with molecular adsorbent recycling system （MARS） as preoperative liver support therapy. The study included two parts, the first one is to evaluate the medical effectiveness of single MARS treatment with some clinical and laboratory parameters, which were supposed to be the therapeutical pre-transplant risk factors, the second part is to study the patients undergoing OLT using the regression analysis on preoperative risk factors relating to early mortality （30 d） after OLT. RESULTS： In the 50 patients, the statistically significant improvement in the biochemical parameters was observed （pre-treatment and post-treatment）. Eight patients avoided the scheduled Ltx due to significant relief of clinical condition or recovery of failing liver function, 8 patients died, 34 patients were successfully bridged to Ltx, the immediate outcome of this 34 patients within 30d observation was： 28 kept alive and 6 patients died. CONCLUSION： Pre-operative SOFA, level of creatinine, INR, TNF-α, IL-10 are the main preoperative risk factors that cause early death after operation, MARS treatment before transplantion can relieve these factors significantly.

关键词： Liver transplantation Artificial liver Sequential Organ Failure Assessment risk factors analysis

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