SERIOUS PARACETAMOL POISONING AND THE RESULTS OF LIVER-TRANSPLANTATION
SERIOUS PARACETAMOL POISONING AND THE RESULTS OF LIVER-TRANSPLANTATION
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DOI：
10.1136/gut.35.6.809
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发表时间：
1994-06-01
期刊：
影响因子：
24.5
通讯作者：
ELIAS, E
中科院分区：
文献类型：
--
作者：
MUTIMER, DJ;AYRES, RCS;ELIAS, E
扑热息痛中毒是英国暴发性肝功能衰竭的最常见原因。在转诊时准确评估预后将允许在这种情况下适当应用肝移植。对连续入住肝脏专科病房的92名严重中毒患者的结局进行了检查。在未接受移植的患者中，26/82例（32%）出现致死性结局，与晚期表现、昏迷分级、凝血酶原时间延长、代谢性酸中毒和肾功能不全相关。脑水肿和败血症是大多数死亡的原因。在国王学院医院定义的预后标准似乎可以预测那些没有在伯明翰肝脏单位进行移植的患者的预后。17例患者被列为移植，10例接受肝移植，10例中有7例存活。七个人被列入名单，但没有移植，七个人中有一个活了下来。移植病人的心理康复并不困难。这些结果表明，肝移植在治疗对乙酰氨基酚中毒患者中的作用。
Paracetamol poisoning is the most common cause of fulminant liver failure in the United Kingdom. An accurate assessment of prognosis at the time of referral will allow the appropriate application of liver transplantation in this setting. The outcome of 92 patients consecutively admitted to a specialist liver unit with severe poisoning has been examined. In patients who did not have a transplant, a fatal outcome was seen for 26/82 (32%), and was associated with late presentation, coma grade, prothrombin time prolongation, metabolic acidosis, and renal dysfunction. Cerebral oedema, and sepsis were responsible for most deaths. Prognostic criteria defined at King's College Hospital seemed to predict the outcome of patients who did not have a transplant managed on the Birmingham liver unit. Seventeen patients were listed for transplantation, 10 had liver transplantation, and seven of 10 survived. Seven were listed but not transplanted, and one of seven survived. Psychological rehabilitation of patients who had a transplant has not proved difficult. These results suggest a role for liver transplantation in the management of selected patients with paracetamol poisoning.