Volume 10 Issue 3
May  2019
Turn off MathJax
Article Contents
Article Navigation >  ORGAN TRANSPLANTATION  > 2019  >  10(3): 318-322
Zhou Zhengjun, Li Jiequn, Bin Yangyang, et al. Effect of donor risk index on early prognosis of liver transplantation for acute-on-chronic liver failure: experience of 159 cases in one single center[J]. ORGAN TRANSPLANTATION, 2019, 10(3): 318-322. doi: 10.3969/j.issn.1674-7445.2019.03.016
Citation: Zhou Zhengjun, Li Jiequn, Bin Yangyang, et al. Effect of donor risk index on early prognosis of liver transplantation for acute-on-chronic liver failure: experience of 159 cases in one single center[J]. ORGAN TRANSPLANTATION, 2019, 10(3): 318-322. doi: 10.3969/j.issn.1674-7445.2019.03.016
shu

Effect of donor risk index on early prognosis of liver transplantation for acute-on-chronic liver failure: experience of 159 cases in one single center

doi: 10.3969/j.issn.1674-7445.2019.03.016

  • Department of General Surgery and Organ Transplantation, the Second Xiangya Hospital of Central South University, Changsha 410013, China

More Information
  • Corresponding author: Hu Wei, Email: huwei4660@126.com
  • Received Date: 2019-03-03
    Available Online: 2021-01-19
  • Publish Date: 2019-05-15
    Abstract
  •   Objective  To evaluate the effect of donor risk index (DRI) on the early prognosis of liver transplantation for acute-on-chronic liver failure (ACLF).  Methods  Clinical data of 159 ACLF recipients undergoing liver transplantation were retrospectively analyzed. According to the calculation formula of DRI, all recipients were divided into DRI < 1.65 group (n=96) and DRI≥1.65 group (n=63). Based on the Chronic Liver Failure Consortium acute-on-chronic liver failure score (CLIF-C ACLFs), all recipients were divided into CLIF-C ACLFs < 48 group (n=78) and CLIF-C ACLFs≥48 group (n=81). The early prognosis indexes including the length of intensive care unit (ICU) stay and the length of postoperative hospital stay of the recipients in each group were observed after liver transplantation. The 90 dsurvival rate of the recipients after liver transplantation was analyzed by Kaplan-Meier survival curve. The risk factors affecting the early prognosis of ACLF recipients after liver transplantation were analyzed by Cox's hazards regression model.  Results  The length of ICU stay and the length of postoperative hospital stay did not significantly differ between the DRI < 1.65 group and DRI≥1.65 group (both P > 0.05). The length of postoperative hospital stay did not significantly differ between the CLIF-C ACLFs < 48 group and CLIF-C ACLFs≥48 group (P > 0.05). The length of ICU stay in the CLIF-C ACLFs < 48 group was 4 (3-14) d, significantly shorter than 7 (1-33) d in the CLIF-C ACLFs≥48 group (P < 0.05). The CLIF-C ACLFs was a risk factor of the early prognosis of ACLF recipients after liver transplantation (P < 0.05). The postoperative 90 d survival rate did not significantly differ between the DRI < 1.65 group and DRI≥1.65 group (P > 0.05). The postoperative 90 d survival rate in the CLIF-C ACLFs < 48 group was 94%, significantly higher than 79% in the CLIF-C ACLFs≥48 group (P < 0.05).  Conclusions  The early prognosis of ACLF recipients after liver transplantation is correlated with the severity of the disease rather than the DRI. Liver transplantation should be performed early and promptly.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    PEZZATI D, HASSAN A, BUCCINI L, et al. Liver transplantation with geriatric liver allograft in the US: a matter of epidemiology or outcome requirements? [J]. Transpl Int, 2017, 30(11):1190-1191. DOI: 10.1111/tri.13013.
    [2]
    JALAN R, GINES P, OLSON JC, et al. Acute-on chronic liver failure[J]. J Hepatol, 2012, 57(6):1336-1348. DOI: 10.1016/j.jhep.2012.06.026.
    [3]
    MOREAU R, JALAN R, GINES P, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis[J]. Gastroenterology, 2013, 144(7):1426-1437. DOI: 10.1053/j.gastro.2013.02.042.
    [4]
    FENG S, GOODRICH NP, BRAGG-GRESHAM JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index[J]. Am J Transplant, 2006, 6(4):783-790. doi: 10.1111/j.1600-6143.2006.01242.x
    [5]
    ARROYO V. Acute-on-chronic liver failure in cirrhosis requires expedited decision for liver transplantation[J]. Gastroenterology, 2019, 156(5):1248-1249. DOI: 10.1053/j.gastro.2019.03.004.
    [6]
    邓斐文, 陈焕伟, 甄作均.公民逝世后器官捐献供肝肝移植单中心经验总结[J].器官移植, 2017, 8(6):435-439. DOI: 10.3969/j.issn.1674-7445.2017.06.005.

    DENG FW, CHEN HW, ZHEN ZJ. Liver transplantation from donor liver of organ donation after citizens' death: a single center experience[J]. Organ Transplant, 2017, 8(6):435-439. DOI: 10.3969/j.issn.1674-7445.2017.06.005.
    [7]
    HUEBENER P, STERNECK MR, BANGERT K, et al. Stabilisation of acute-on-chronic liver failure patients before liver transplantation predicts post-transplant survival[J]. Aliment Pharmacol Ther, 2018, 47(11):1502-1510. DOI: 10.1111/apt.14627.
    [8]
    ZEYTUNLU M, UĞUZ A, ÜNALP Ö, et al. Results of 1001 liver transplantations in 23 years: Ege University experience[J]. Turk J Gastroenterol, 2018, 29(6):664-668. DOI: 10.5152/tjg.2018.18058.
    [9]
    JALAN R, SALIBA F, PAVESI M, et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure[J]. J Hepatol, 2014, 61(5):1038-1047. DOI: 10.1016/j.jhep.2014.06.012.
    [10]
    LI N, HUANG C, YU KK, et al. Validation of prognostic scores to predict short-term mortality in patients with HBV-related acute-on-chronic liver failure: the CLIF-C OF is superior to MELD, CLIF SOFA, and CLIF-C ACLF[J]. Medicine (Baltimore), 2017, 96(17):e6802. DOI: 10.1097/MD.0000000000006802.
    [11]
    SZYMCZAK M, KALICIŃSKI P, KOWALEWSKI G, et al. Combined liver-kidney transplantation in children: single-center experiences and long-term results[J]. Transplant Proc, 2018, 50(7):2140-2144. DOI: 10.1016/j.transproceed.2018.04.061.
    [12]
    BONNEY GK, ALDERSLEY MA, ASTHANA S, et al. Donor risk index and MELD interactions in predicting long-term graft survival: a single-centre experience[J]. Transplantation, 2009, 87(12):1858-1863. DOI: 10.1097/TP.0b013e3181a75b37.
    [13]
    BIGGINS SW, GRALLA J, DODGE JL, et al. Survival benefit of repeat liver transplantation in the United States: a serial MELD analysis by hepatitis C status and donor risk index[J]. Am J Transplant, 2014, 14(11):2588-2594. DOI: 10.1111/ajt.12867.
    [14]
    CHOLONGITAS E, THEOCHARIDOU E, VASIANOPOULOU P, et al. Comparison of the sequential organ failure assessment score with the King's College Hospital criteria and the model for end-stage liver disease score for the prognosis of acetaminophen-induced acute liver failure[J]. Liver Transpl, 2012, 18(4):405-412. DOI: 10.1002/lt.23370.
    [15]
    CHOUDHARY NS, SARAF N, SAIGAL S, et al. Liver transplantation for acute on chronic liver failure[J]. J Clin Exp Hepatol, 2017, 7(3):247-252. DOI: 10.1016/j.jceh.2017.08.001.
    [16]
    PAMECHA V, KUMAR S, BHARATHY KG. Liver transplantation in acute on chronic liver failure: challenges and an algorithm for patient selection and management[J]. Hepatol Int, 2015, 9(4):534-542. DOI: 10.1007/s12072-015-9646-9.
    [17]
    LI H, CHEN LY, ZHANG NN, et al. Characteristics, diagnosis and prognosis of acute-on-chronic liver failure in cirrhosis associated to hepatitis B[J]. Sci Rep, 2016, 6:25487. DOI: 10.1038/srep25487.
    [18]
    HARRING TR, NGUYEN NT, COTTON RT, et al. Liver transplantation with donation after cardiac death donors: a comprehensive update[J]. J Surg Res, 2012, 178(1):502-511. DOI: 10.1016/j.jss.2012.04.044.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (156) PDF downloads(25) Cited by()
    Proportional views
    Related

    WeChat Subscription Account

    Wechat Service Account

    Contact Us
    • Tel：020-38736410
    • Email: organtranspl@163.com
    • Address：The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou
    • Editorial Office of Organ Transplantation  粤ICP备2021030844号
    Links

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return