Effect of donor risk index on early prognosis of liver transplantation for acute-on-chronic liver failure: experience of 159 cases in one single center
10.3969/j.issn.1674-7445.2019.03.016
- VernacularTitle:供体风险指数对慢加急性肝衰竭肝移植治疗早期预后的影响：单中心159例经验
- Author:
Zhengjun ZHOU
1
;
Jiequn LI
;
Yangyang BIN
;
Guangshun CHEN
;
Qiang LI
;
Haizhi QI
;
Zhongzhou SI
;
Wei HU
Author Information
1. Department of General Surgery and Organ Transplantation, the Second Xiangya Hospital of Central South University, Changsha 410013, China
- Publication Type:Research Article
- Keywords:
Acute-on-chronic liver failure;
Liver transplantation;
Donor risk index;
Chronic Liver Failure Consortium organ failure score;
Chronic liver failure sequential organ failure assessment score;
Chronic Liver Failure Consortium acute-on-chronic liver failure score
- From:
Organ Transplantation
2019;10(3):318-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of donor risk index (DRI) on the early prognosis of liver transplantation for acute-on-chronic liver failure (ACLF). Methods Clinical data of 159 ACLF recipients undergoing liver transplantation were retrospectively analyzed. According to the calculation formula of DRI, all recipients were divided into DRI < 1.65 group (n=96) and DRI≥1.65 group (n=63). Based on the Chronic Liver Failure Consortium acute-on-chronic liver failure score (CLIF-C ACLFs), all recipients were divided into CLIF-C ACLFs < 48 group (n=78) and CLIF-C ACLFs≥48 group (n=81). The early prognosis indexes including the length of intensive care unit (ICU) stay and the length of postoperative hospital stay of the recipients in each group were observed after liver transplantation. The 90 dsurvival rate of the recipients after liver transplantation was analyzed by Kaplan-Meier survival curve. The risk factors affecting the early prognosis of ACLF recipients after liver transplantation were analyzed by Cox's hazards regression model. Results The length of ICU stay and the length of postoperative hospital stay did not significantly differ between the DRI < 1.65 group and DRI≥1.65 group (both P > 0.05). The length of postoperative hospital stay did not significantly differ between the CLIF-C ACLFs < 48 group and CLIF-C ACLFs≥48 group (P > 0.05). The length of ICU stay in the CLIF-C ACLFs < 48 group was 4 (3-14) d, significantly shorter than 7 (1-33) d in the CLIF-C ACLFs≥48 group (P < 0.05). The CLIF-C ACLFs was a risk factor of the early prognosis of ACLF recipients after liver transplantation (P < 0.05). The postoperative 90 d survival rate did not significantly differ between the DRI < 1.65 group and DRI≥1.65 group (P > 0.05). The postoperative 90 d survival rate in the CLIF-C ACLFs < 48 group was 94%, significantly higher than 79% in the CLIF-C ACLFs≥48 group (P < 0.05). Conclusions The early prognosis of ACLF recipients after liver transplantation is correlated with the severity of the disease rather than the DRI. Liver transplantation should be performed early and promptly.
