Does the Model for End-stage Liver Disease Score Predict Transfusion Amount, Acid-Base Imbalance, Haemodynamic and Oxidative Abnormalities during Living Donor Liver Transplantation?
Does the Model for End-stage Liver Disease Score Predict Transfusion Amount, Acid-Base Imbalance, Haemodynamic and Oxidative Abnormalities during Living Donor Liver Transplantation?
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DOI：
10.1177/147323001103900520
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发表时间：
2011-09-01
影响因子：
1.6
通讯作者：
Chung, M. Y.
中科院分区：
文献类型：
--
作者：
Lee, J.;Chung, M. Y.
终末期肝病模型（MELD）评分与移植患者肝功能衰竭的严重程度相关。本研究探讨了肝移植术期间危及生命的应激因素是否因患者术前MELD评分而异。44例活体肝移植患者分为高MELD组（MELD评分≥ 20分）（n = 25）和低MELD组（MELD评分< 20分）（n = 19）。在手术的每个阶段测量输血量、酸碱平衡变量以及血液动力学和氧化变量。在所有时间点，高MELD组的体循环血管阻力指数均显著低于低MELD组。高MELD组的氧利用指数和氧摄取率仅在无肝前期显著低于低MELD组，而在手术后期无显著差异。术中输血量和代谢性酸中毒的严重程度与术前MELD评分无关。
The model for end-stage liver disease (MELD) score is associated with the severity of liver failure in transplant patients. This study examined whether life-threatening stress factors during liver transplantation differed according to the patients' preoperative MELD scores. Forty-four patients who underwent living donor liver transplantation were divided into a high MELD group (MELD score >= 20) (n = 25) and a low MELD group (MELD score < 20) (n = 19). The volume of blood components transfused, acid-base homeostasis variables, and haemodynamic and oxidative variables were measured at each stage of the surgery. The systemic vascular resistance index was significantly lower in the high MELD group than in the low MELD group at all time points. The oxygen utility index and the oxygen extraction ratio were all significantly lower in the high MELD group than in the low MELD group only at the preanhepatic stage and not at later stages of surgery. Intraoperative transfusion volume and the severity of metabolic acidosis were not associated with the preoperative MELD score.