维普中文期刊产品整合服务

Evaluation of the updated definition of early allograft dysfunction in donation after brain death and donation after cardiac death liver allografts

查看全文 作　　者：Kris P [1,2]Croome;William [1,2]Wall;Douglas [1,2]Quan;Sai [1]Vangala;Vivian [1,2]McAlister;Paul [1,3]Marotta;Roberto Hernandez-[1]Alejandro 高影响力作者 机构地区：[1]Multi-Organ Transplant Program,London Health Sciences Centre,The University of Western Ontario,London,Canada;[2]Department of Surgery,Division of General Surgery,The University of Western Ontario,London,Canada;[3]Division of Gastroenterology,The University of Western Ontario,London,Canada高影响力机构 出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2012年第11卷第4期,共5页高影响力期刊 摘　　要：BACKGROUND:An updated definition of early allograft dysfunction(EAD) was recently validated in a multicenter study of 300 deceased donor liver transplant recipients.This analysis did not differentiate between donation after brain death(DBD) and donation after cardiac death(DCD) allograft recipients.METHODS:We reviewed our prospectively entered database for all DBD(n=377) and DCD(n=38) liver transplantations between January 1,2006 and October 30,2011.The incidence of EAD as well as its ability to predict graft failure and survival was compared between DBD and DCD groups.RESULTS:EAD was a valid predictor of both graft and patient survival at six months in DBD allograft recipients,but in DCD allograft recipients there was no significant difference in the rate of graft failure in those with EAD(11.5%) compared with those without EAD(16.7%)(P=0.664) or in the rate of death in recipients with EAD(3.8%) compared with those without EAD(8.3%)(P=0.565).The graft failure rate in the first 6 months in those with international normalized ratio ≥1.6 on day 7 who received a DCD allograft was 37.5% compared with 6.7% for those with international normalized ratio <1.6 on day 7(P=0.022).CONCLUSIONS:The recently validated definition of EAD is a valid predictor of patient and graft survival in recipients of DBD allografts.On initial assessment,it does not appear to be a useful predictor of patient and graft survival in recipients of DCD allografts,however a study with a larger sample size of DCD allografts is needed to confirm these findings.The high ALT/AST levels in most recipients of DCD livers as well as the predisposition to biliary complications and early cholestasis make these parameters as poor predictors of graft failure.An alternative definition of EAD that gives greater weight to the INR on day 7 may be more relevant in this population. 关 键 词：donor risk index model for END-STAGE LIVER disease EARLY allograft dysfunction DONATION AFTER brain death
相关文献

参考文献(20)

引证文献(15)

耦合文献(14)

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1　渝公网安备 50019002500403号　违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费