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低纤维解质活性通过旋转性血栓收缩仪的评估和肝移植的结果:单中心前性研究

Jacopo Belfiore¹, Niccolò Castellani Nicolini¹, M Lucia Bindi¹

¹Transplant Anesthesia and Intensive Care Unit, University of Pisa, Pisa, Italy.

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

|September 17, 2025

概括

低纤维溶解活性 (LFA) 在肝移植 (LT) 患者中很常见. 这种情况显著预测了状血栓和28天死亡率,突出了ROTEM.

科学领域:

移植医学移植医学
肝病学肝病学是一种肝病学.
关键护理医学关键护理医学

背景情况:

肝移植 (LT) 是对末期肝病 (ESLD) 的一个拯救生命的程序.
静血性障碍,特别是低纤维解酶活性 (LFA),是LT的常见并发症.
低血压与不良结果有关,包括脊柱血栓形成和死亡率增加.

研究的目的:

为了确定LT期间LFA的发病率.
评估LFA与血栓形成/临床结果之间的关联.
评估LFA对LT后28天死亡率的预测值.

主要方法:

对222名接受LT治疗的ESLD患者进行前性观察性研究.
旋转性血小板造影仪 (ROTEM) 用于在四个时间点测量LFA.
结果包括状血栓,28天死亡率,PRS,re-LT和MBT.

主要成果:

在27.5%的患者中发生LFA.
LFA强烈预测了状血栓 (OR=32.7) 和28天死亡率 (OR=8.7).
ROTEM显示出对血栓形成的良好预测准确性 (AUC=0.84) 和对死亡率的良好准确性 (AUC=0.75).

结论:

由ROTEM确定的LFA是LT中不利结果的重要预测因素.
实时ROTEM分析提供了关键的预后信息.
需要进一步的多中心研究来确认ROTEM的实用性,并探索LFA机制.

关键词:

肝移植肝移植肝移植纤维溶解活性较低的纤维溶解活性.血小板凝块收缩血小板凝块收缩旋转性血栓弹性测试 (Thromboelastometry) 是一种旋转性血栓弹性测试.

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