急性肝衰竭对慢性肝衰竭对移植后生存率的影响
Carlos Benítez1, Jorge Arnold1, Verónica Cambindo1
1Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
Annals of hepatology
|June 18, 2023
概括
急性至慢性肝衰竭 (ACLF) 显著降低了肝移植后的一年生存率. ACLF患者需要更多的资源,突出其对移植后结果的影响.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
- 关键护理医学 关键护理医学
背景情况:
- 急性至慢性肝衰竭 (ACLF) 在肝移植中是一个重大挑战,通常与较差的结果有关.
- 肝移植是ACLF的关键干预措施,但其在这些患者中的成功仍然令人担忧.
研究的目的:
- 评估ACLF对移植后一年生存时间的影响.
- 确定与 ACLF 和没有 ACLF 的肝移植接受者死亡率相关的移植前和移植后变量.
主要方法:
- 2013年至2020年间在两个大学中心接受肝移植的成年肝硬化患者的回顾性分析.
- 在患有ACLF和没有ACLF的患者之间比较一年生存率.
- 使用考克斯回归分析识别死亡率的独立预测因素.
主要成果:
- 总共包括303名患者;75人患有ACLF. 在ACLF患者中,一年生存率显著降低 (74.7%与91.2%,p=0.001).
- 移植前的ACLF是生存的独立预测因子 (HR 3.2).
- 移植后的置换疗法 (HR 2.8) 和真菌感染 (HR 3.26) 独立地与死亡率相关.
结论:
- ACLF是肝移植后减少1年生存时间的独立预测因子.
- 与非ACLF接受者相比,患有ACLF的肝移植接受者需要更多的资源利用.
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