| Autor: |
de Rave, Sjoerd, Tilanus, Hugo, van der Linden, Joke, de Man, Robert, van der Berg, Bart, Hop, Wim, Ijzermans, Jan, Zondervan, Pieter, Metselaar, Herold |
| Zdroj: |
Transplant International; January 2002, Vol. 15 Issue: 1 p29-33, 5p |
| Abstrakt: |
Selection of patients with acute hepatic failure for liver transplantation remains difficult, and there is no definite proof of a survival effect. We therefore did a retrospective study in 75 consecutive patients referred over a 12-year period. In two-thirds we identified a cause, mostly viruses or drugs. Patients were grouped by the Clichy and King's College criteria. In 20 there was no indication for transplantation. Of the 5 with autoimmune hepatitis, 3 died, significantly differing from the other 15 (P=0.009). The remaining 55 met our criteria, except 1. All 9 patients with absolute contraindications died. Of the 46 enlisted, 7 died without transplantation. One-year survival after transplantation was 69%, compared with 58% by "intention to treat." For patients enlisted, transplantation reduced mortality by 78% (P=0.069). The Clichy and King's College criteria reliably predict survival without transplantation, except in autoimmune hepatitis. Our study strongly suggests that transplantation improves survival. |
| Databáze: |
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