Operative timing of liver transplantation for patients with severe hepatitis

Autor: Qiu-Cheng, Cai, Yi, Jiang, Li-Zhi, Lv, Huan-Zhang, Hu, Xiao-Jin, Zhang, Yong-Biao, Chen, Shao-Hua, Chen, Kun, Zhang, Fang, Yang, Wei-Ming, Wei, Fan, Pan, Shao-Geng, Zhang, Hua, Lin
Rok vydání: 2009
Předmět:
Zdroj: Hepatobiliarypancreatic diseases international : HBPD INT. 8(5)
ISSN: 1499-3872
Popis: Fulminant hepatic failure manifests a rapid onset, serious complications, and a high mortality, but still there is a possibility of recovery. Once the patient is able to pass a crisis, the liver is able to regenerate completely and regain its normal function. Therefore it is of vital importance to determine the eligible timing for transplantation. Premature surgery might result in a loss of the chance of internal medical treatment and misuse of liver resources, whereas delayed surgery might increase the difficulty of treatment in the preoperative period and the possibility of complications and medical expense, which eventually result in decreased rate of success and survival. This problem remains worldwide how to choose the optional timing of operation.Thirty-six patients with severe hepatitis were treated by orthotopic liver transplantation. The distribution of MELD scores in these patients was: 10-19 in 8 patients, 20-29 in 10, 30-39 in 11, and 40 in 7. They were divided into two groups: MELD score30 and MELD scoreor=30. Parameters (1-year survival rate, complications, preoperative use of artificial liver, operative time, volume of bleeding and blood transfusion, and average hospital costs) were examined as prognostic factors after liver transplantation.The 1-year survival rate of the MELD score30 group was higher than that of theor=30 group (77.8% and 33.3%, P=0.007), and the rate of complications in the30 group was lower (P=0.012). There were no differences in the timing of artificial liver treatment, operative time, operative hemorrhage, and transfusion between the two groups (P=0.742). But the average daily hospital cost in the MELD scoreor=30 group was higher (P=0.008).This study shows that when the MELD score is30 it may be the optimal time to perform liver transplantation for patients with severe hepatitis.
Databáze: OpenAIRE