Liver depurative techniques: a single liver transplantation center experience.

Autor: Rodrigues J; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain., Castro SG; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain., Moya B; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain., Fortuna P; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain., Martins A; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain., Pereira JP; Hospital Curry Cabral, Liver Transplantation Unit, Lisbon, Portugal., Bento L; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain., Perdigoto R; Hospital Curry Cabral, Liver Transplantation Unit, Lisbon, Portugal., Barroso E; Hospital Curry Cabral, Liver Transplantation Unit, Lisbon, Portugal., Marcelino P; Hospital Curry Cabral, Intensive Care Unit, Lisbon, Spain. Electronic address: jp.azevedo.rodrigues@gmail.com.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2015 May; Vol. 47 (4), pp. 996-1000.
DOI: 10.1016/j.transproceed.2015.03.016
Abstrakt: Background: In a liver transplant (LT) center, treatments with Prometheus were evaluated. The main outcome considered was 1 and 6 months survival.
Methods: During the study period, 74 patients underwent treatment with Prometheus; 64 were enrolled, with a mean age of 51 ± 13 years; 47 men underwent 212 treatments (mean, 3.02 per patient). The parameters evaluated were age, sex, laboratorial (liver enzymes, ammonia) and clinical (model for end-stage liver disease and Child-Turcotte-Pugh score) data.
Results: Death was verified in 23 patients (35.9%) during the hospitalization period, 20 patients (31.3%) were submitted to liver transplantation, and 21 were discharged. LT was performed in 4 patients with acute liver failure (ALF, 23.7%), in 7 patients with acute on chronic liver failure (AoCLF, 43.7%), and in 6 patients with liver disease after LT (30%). Seven patients who underwent LT died (35%). In the multivariate analysis, older age (P = .015), higher international normalized ratio (INR) (P = .019), and acute liver failure (P = .039) were independently associated with an adverse 1-month clinical outcome. On the other hand, older age (P = .011) and acute kidney injury (P = .031) at presentation were both related to worse 6-month outcome. For patients with ALF and AoCLF we did not observe the same differences.
Conclusions: In this cohort, older age was the most important parameter defining 1- and 6-month survival, although higher INR and presence of ALF were important for 1-month survival and AKI for 6-month survival. No difference was observed between patients who underwent LT or did not have LT.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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