The vexing triad of obesity, alcohol, and coagulopathy predicts the need for multiple operations in liver transplantation.
The vexing triad of obesity, alcohol, and coagulopathy predicts the need for multiple operations in liver transplantation.
复制标题
肥胖、酗酒和凝血障碍这三大烦恼预示着肝移植需要多次手术。
DOI：
10.1016/j.amjsurg.2022.02.053
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发表时间：
2022-07
影响因子：
3
通讯作者：
Nydam, Trevor L.
中科院分区：
文献类型：
--
作者：
Moore, Hunter B.;Bababekov, Yanik J.;Pomposelli, James J.;Adams, Megan A.;Crouch, Cara;Yoeli, Dor;Choudhury, Rashikh A.;Ferrell, Tanner;Burton, James R.;Pomfret, Elizabeth A.;Nydam, Trevor L.
四分之一的肝移植 (LT) 需要在手术后 48 小时内返回手术室 (R-OR)。我们假设供体、受体和术中因素将预测 R-OR。 LT 受者参加了一项观察性研究，通过血栓弹力图 (TEG) 测量凝血情况，并使用移植受者和供者变量评估 R-OR 风险。对 160 名接受者进行了分析，他们的中位年龄为 55 岁，MELD-Na 为 22。 R-OR 发生率为 22%。受者 BMI (p=0.006)、供者大量饮酒 (p=0.017)、手术无肝期 TEG MA (p=0.013)、无肝期和再灌注后 30 分钟的 TEG MA (p<0.05) 以及红细胞输注 (p<0.001) 与 R-OR 相关。受者肥胖、捐献者大量饮酒和低 TEG MA 等令人烦恼的三联征与高 R-OR 率相关。减少这种次优风险因素组合的策略可以减少计划外再次手术的频率。
One in four liver transplants (LT) require return to the operating room(R-OR) within 48 hours of surgery. We hypothesize that donor, recipient, and intraoperative factors will predict R-OR. LT recipients were enrolled in an observational study to measure coagulation with thrombelastography (TEG) were assessed with transplant recipient and donor variables for risk of R-OR. 160 recipients with a median age of 55 years and a MELD-Na of 22 were analyzed. R-OR occurred in 22%. Recipient BMI (p=0.006), donor heavy alcohol use (p=0.017), TEG MA (p=0.013) during the anhepatic phase of surgery, TEG MA at anhepatic and 30-minutes after reperfusion (p<0.05), and red blood cell transfusions (p<0.001) were associated with R-OR. The vexing triad of recipient obesity, heavy donor alcohol use, and low TEG MA were associated with a high rate of R-OR. Strategies to reduce this sub-optimal combination of risk factors could reduce the frequency of unplanned re-operations.
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影响因子：
2.1
作者：
Nicolau-Raducu, Ramona;Cohen, Ari J.;Loss, George
通讯作者：
Loss, George
影响因子：
6.2
作者：
Arora, Sumant S.;Chahal, Khushdeep S.;Singal, Ashwani K.
通讯作者：
Singal, Ashwani K.
影响因子：
2.3
作者：
Pearson, Terra;Zimmerman, Michael A.;Hong, Johnny C.
通讯作者：
Hong, Johnny C.
影响因子：
6.2
作者：
PORTE, RJ;BONTEMPO, FA;STARZL, TE
通讯作者：
STARZL, TE
DOI：
10.1111/tri.14123
发表时间：
2021-12
期刊：
Transplant international : official journal of the European Society for Organ Transplantation
影响因子：
--
作者：
Ivanics T;Leonard-Murali S;Mouzaihem H;Moonka D;Kitajima T;Yeddula S;Shamaa MT;Rizzari M;Collins K;Yoshida A;Abouljoud M;Nagai S
通讯作者：
Nagai S