Detection of early allograft dysfunction at 30 min of reperfusion in liver transplantation: An intraoperative diagnostic tool with real time assessment of graft function.
Detection of early allograft dysfunction at 30 min of reperfusion in liver transplantation: An intraoperative diagnostic tool with real time assessment of graft function.
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DOI：
10.1016/j.amjsurg.2020.08.018
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发表时间：
2020-12
影响因子：
3
通讯作者：
Nydam TL
中科院分区：
文献类型：
--
作者：
Moore HB;Yaffe H;Pomposelli JJ;Wachs M;Bak T;Kennealey P;Conzen K;Adams M;Pshak T;Choudhury R;Walker C;Schulick A;Ferrell T;Chapman MP;Pomfret EA;Nydam TL
在肝移植（LT）的无肝期，纤溶活性增加，因为肝脏清除组织纤溶酶原激活剂（tPA）。我们推测，移植物再灌注后不能降低纤溶活性的患者，早期同种异体移植物功能障碍（EAD）的发生率会增加。用血栓弹力图（TEG）LY 30定量评估肝移植受者的纤溶情况。观察移植肾再灌注后LY 30的变化。从定量纤维蛋白溶解变化的无肝LY 30中减去再灌注后30分钟的LY 30（Δ-LY 30）。73例原发性LT患者纳入分析。受试者工作特征曲线（ROC）分析将delta-LY 30 −5.3%的拐点确定为EAD的风险因素。这些患者中有44%发生EAD，而在高Δ-LY 30患者中为5%（p=0.002）。发生纤溶亢进的LT受体在移植物再灌注后30分钟未能降低纤溶活性，其EAD率是再灌注后LY 30大幅降低的患者的8倍。
During the anhepatic phase of liver transplantation (LT), fibrinolytic activity increases, since the liver clears tissue plasminogen activator (tPA). We hypothesize that patients who fail to reduce fibrinolytic activity following graft reperfusion will have an increased rate of early allograft dysfunction (EAD). Assessment of fibrinolysis in liver transplant recipients was quantified with thrombelastography (TEG) LY30. Changes in LY30 were assessed after graft reperfusion. The 30-minute post-reperfusion LY30 was subtracted from the anhepatic LY30 quantifying fibrinolytic changes (delta-LY30). Seventy-three primary LT patients were included in the analysis. Receiver operating characteristic curve (ROC) analysis identified an inflection point of delta-LY30 −5.3% as a risk factor for EAD. EAD occurred in 44% of these patients compared to 5% in high delta-LY30 (p=0.002). LT recipients that develop hyperfibrinolysis who fail to reduce fibrinolytic activity 30 minutes after graft reperfusion had an EAD rate 8-fold higher than patients who had a large reduction in LY30 following reperfusion.
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影响因子：
9
作者：
HARDAWAY, RM;DRAKE, DC
通讯作者：
DRAKE, DC
影响因子：
1.1
作者：
Kim, Eun-Hee;Ko, Justin S.;Kim, Gaab-Soo
通讯作者：
Kim, Gaab-Soo
影响因子：
2.4
作者：
Lozano Lominchar, Pablo;Igone Orue-Echebarria, Maitane;Angel Lopez-Baena, Jose
通讯作者：
Angel Lopez-Baena, Jose
DOI：
10.1111/ajt.15276
发表时间：
2019-02-01
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Kim, W R;Lake, J R;Kasiske, B L
通讯作者：
Kasiske, B L
影响因子：
4.6
作者：
Deschenes, Marc
通讯作者：
Deschenes, Marc