Impact of cumulative risk factors for expanded criteria donors on early survival after liver transplantation
Impact of cumulative risk factors for expanded criteria donors on early survival after liver transplantation
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DOI：
10.1016/j.transproceed.2008.03.017
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发表时间：
2008-04-01
影响因子：
0.9
通讯作者：
Ferraz-Neto, B. H.
中科院分区：
文献类型：
--
作者：
Afonso, R. C.;Hidalgo, R.;Ferraz-Neto, B. H.
有多种选择可以帮助克服器官短缺，包括使用边缘供体的移植物进行移植，这些供体的特征以前被描述为不可接受，因为移植失败的风险很高。如今，扩大标准供者肝移植（奥尔特）是许多团队常规使用的策略。一些供体特征已被认为会危及初始功能或生存;当这些特征聚集在一起时，它们可能会影响预后。本研究的目的是评估供体风险因素对早期患者生存和再次移植的影响。供体危险因素被认为是年龄大于60岁，体重指数> 30，血清钠水平> 155 mEq/L，冷缺血时间> 12小时，重症监护室停留> 4天。我们前瞻性地记录了2003年3月至2007年5月期间接受152例奥尔特的139例患者的数据。患者分为四组：1，无危险因素; 11，1个危险因素; 111，2个危险因素; IV，3个或更多危险因素。急性肝功能衰竭导致的再次移植或奥尔特被认为是排除标准。早期总生存率为83.76%，再次移植12例（10.25%）。比较四组，患者生存率（P = 0.41）和再次移植率（P = 0.518）相似。总之，累积的风险因素显示对早期（30天）受体存活率和/或奥尔特后再次移植的必要性没有影响。
There are various options to help overcome the organ shortage, including performing transplants using grafts from marginal donors with characteristics previously described as unacceptable because of the high risk of graft failure. Nowadays, expanded criteria donors for liver transplantation (OLT) is a strategy used routinely by many teams. Some donor features have been suggested to jeopardize initial function or survival; when these features are aggregated, they may impact prognosis. The aim of this study was to evaluate the impact of donor risk factors on early patient survival and retransplantation. Donor risk factors were considered to be older than 60 years, body mass index > 30, serum sodium level > 155 mEq/L, cold ischemia time > 12 hours, and intensive care unit stay > 4 days. We prospectively recorded data from 139 patients who underwent 152 OLT from March 2003 to May 2007. Patients were classified into four groups: 1, no risk factors; 11, one risk factor; 111, two risk factors; IV, three or more risk factors. Retransplantation or OLT due to acute liver failure was considered to be an exclusion criterion. Early overall survival rate was 83.76%; 12 retransplantations were required (10.25%). Comparing the four groups, patient survivals (P =.41) and retransplantation rates (P =.518) were similar. In conclusion, cumulative risk factors showed no impact on early (30-day) recipient survival and or on the necessity of retransplantation after OLT.