Research on clinical efficacy of liver transplantation for severe liver disease
10.3969/j.issn.1674-7445.2020.04.010
- VernacularTitle:肝移植治疗危重症肝病的临床疗效研究
- Author:
Jiantao KOU
1
;
Zhe LIU
;
Jiqiao ZHU
;
Jun MA
;
Wenli XU
;
Han LI
;
Yanan JIA
;
Xianliang LI
;
Qiang HE
Author Information
1. Department of Hepatobiliary-pancreatic-spleen Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
- Publication Type:Journal Article
- Keywords:
evere liver disease;
Liver transplantation;
Hepatic encephalopathy;
Hepatorenal syndrome;
Infection;
Total bilirubin;
Prothrombin time activity;
Prothrombin time international normalized ratio
- From:
Organ Transplantation
2020;11(4):482-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy of liver transplantation for severe liver disease. Methods The clinical data of 51 patients who underwent liver transplantation for severe liver disease were retrospectively analyzed. The general intraoperative conditions were observed, including operation duration, warm ischemia time, cold ischemia time, anhepatic phase, bleeding volume, blood transfusion volume, plasma transfusion volume and so on. The changes in indexes such as total bilirubin (TB), prothrombin time activity (PTA), and prothrombin time international normalized ratio (PT-INR) were observed before operation and at 3 d, 1 week and 2 weeks after operation. The postoperative survival and occurrence of complications were analyzed. The indexes that might affect the prognosis of patients with severe liver disease were analyzed by Cox regression analysis. Results For the 51 patients, operation duration, warm ischemia time and cold ischemia time was 8 (7, 9) h, 3 (2, 3) min and 6 (5, 8) h respectively, intraoperative anhepatic phase was 80 (70, 100) min, intraoperative bleeding volume was 1 000 (550, 1 500) mL, and intraoperative blood transfusion volume was 1 200 (200, 1 600) mL. Postoperative TB, PTA, PT-INR and other indexes improved significantly compared to those preoperatively. Among the 51 patients, 10 cases died, with the death causes of multiple organ failure and severe infection(7 cases), renal insufficiency (2 cases), and cardiovascular complications (1 case). Survival rates at 1 month and 1 year post-transplantation for patients with severe liver disease were 82% and 80%, respectively. Cox regression analysis suggested that abnormal preoperative PTA and PT-INR were the risk factors for post-transplantation death in patients with severe liver disease. Conclusions Liver transplantation significantly improves the survival rate for patients with severe liver disease, perioperative infection prevention and treatment as well as multiple organ function management play key roles in improving post-transplantation survival rate in patients with severe liver disease.
