Value of accordion severity grading system in predicting short-term outcome after orthotopic liver transplantation for severe hepatitis
10.3760/cma.j.issn.0254-1785.2016.12.007
- VernacularTitle:Accordion分级系统在预测重型肝炎肝移植术后早期预后中的作用
- Author:
Qikun ZHANG
;
Menglong WANG
;
Haitao ZHANG
;
Zhen ZHANG
;
Tianchi YANG
- Keywords:
Accordion severity grading system;
Severe hepatitis;
Liver transplantation;
Outcome
- From:
Chinese Journal of Organ Transplantation
2016;37(12):736-741
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of the Accordion severity grading system (ASGS) in predicting short-term outcomes after orthotopic liver transplantation for severe hepatitis by classifying post-surgery complications.Methods The clinical documents of 159 patients were retrospectively analyzed who underwent orthotopic liver transplantation for severe hepatitis between Aug.1,2004 to Sept.1,2014 at our center.Complications were categorized according to the ASGS:grade 1 (mild),grade 2 (moderate),grade 3-5 (severe),and grade 6 (death).Outcome measures included ventilator support time,the length of ICU stay,postoperative recovery time.Spearman rank correlation analysis was used to test the correlation between the different grades with these outcome measures.1-year survival trends of different grade complication groups were demonstrated by Kaplan-Meier method and compared by Log-rank test.Results In total,43 (27.0％) patients had a grade 2 complication;41 (25.8％) grade 3;31 (19.5％) grade 4;9 (5.7％) grade 5;and 35 (22.0％) grade 6.There was no grade 1 patient.There was a significant correlation between the complication grades and the ventilator support time,the length of ICU stay and postoperative inpatient time (P＜0.01).With the increase of the complication grades,the outcome measures were even worse.Severe grade complication group had a longer ventilator support time,the length of ICU stay and postoperative inpatient time than the moderate grade complication group (P＜0.01).There was a significant downward trend in 1-year survival with the increase of the complication grade (P＜0.01).Conclusion The ASGS is helpful to assess risks and predict short-term outcomes after liver transplantation for severe hepatitis.Higher Accordion grades are correlated with even worse short-term outcomes.
