Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non-acetaminophen-related fulminant hepatic failure
| Autor: | Yoshiaki Iwasaki, Yasushi Shiratori, Haruhiko Kobashi, Kouichi Takaguchi, Kohsaku Sakaguchi, Masaharu Ando, Yasuhiro Makino, Yasuhiro Miyake |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Fulminant Liver transplantation Gastroenterology Statistics Nonparametric Cerebral edema Fulminant hepatic failure Risk Factors Internal medicine Humans Medicine Coma Hepatology business.industry Age Factors Liver Failure Acute Middle Aged Prognosis medicine.disease Systemic Inflammatory Response Syndrome Liver Transplantation Surgery Acetaminophen Systemic inflammatory response syndrome Logistic Models Female Prothrombin medicine.symptom business Viral hepatitis medicine.drug |
| Zdroj: | Journal of Gastroenterology and Hepatology. 22:855-861 |
| ISSN: | 1440-1746 0815-9319 |
| DOI: | 10.1111/j.1440-1746.2007.04874.x |
| Popis: | Background and Aim: Many patients continue to die due to the rapid development of cerebral edema and/or multiple organ failure prior to receiving a liver transplantation. Methods: We investigated the prognostic factors associated with 1-week fatal outcomes after the diagnosis of fulminant hepatic failure, which were associated with fatal outcomes prior to receiving liver transplantation, in 104 patients with non-acetaminophen-related fulminant hepatic failure. Results: With a multivariate logistic regression analysis, age (>40 years), systemic inflammatory response syndrome (SIRS) and plasma prothrombin activities (≤10%) were significantly associated with fatal outcomes at 1 week after diagnosis in 104 patients. At the time of diagnosis, 50 patients (48%) were in a state of SIRS. Significant differences were observed between patients with and without SIRS regarding the period from the initial symptoms to the diagnosis of fulminant hepatic failure, hepatic coma grade, serum alanine aminotransferase level, serum creatinine level and plasma prothrombin activity. With a multivariate logistic regression analysis, age (>40 years), cause of fulminant hepatic failure (viral hepatitis), plasma prothrombin activity (≤10%) and no administration of protease inhibitor were significantly associated with the 1-week fatal outcomes of 50 patients with SIRS. Conclusions: Patients with SIRS exhibited hepatic failure of increased severity and SIRS may reduce the probability of receiving a liver transplantation. In order to estimate the efficacy of protease inhibitor for patients with SIRS, a prospective randomized trial is required. |
| Databáze: | OpenAIRE |
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