Journal of Liver Transplantation最新文献

Prospective evaluation of vibration-controlled transient elastography for guiding long-term protocol liver biopsies after liver transplantation 振动控制瞬时弹性成像对指导肝移植术后长期肝活检的前瞻性评价

Journal of Liver Transplantation

Pub Date : 2025-12-30 DOI: 10.1016/j.liver.2025.100317

Bozon-Rivière Pauline , Faure Stéphanie , Ursic Bedoya José , Meszaros Magdalena , Rivière Benjamin , Monet Clément , Moulis Lionel , Herrero Astrid , Guiu Boris , Pageaux Georges-Philippe , Meunier Lucy

Background & Aims

Liver biopsy (LB) is the gold standard for diagnosing post-liver transplantation (LT) complications. Currently, there is no data on the value of vibration-controlled-transient elastography (VCTE) for medium- and long-term follow-up after LT compared to protocol LB in asymptomatic patients. This study aims to evaluate the correlation between VCTE-derived liver stiffness measurements (LSM) and histological abnormalities observed in protocol LB 5 to 10 years after LT, to determine the potential role of VCTE in long-term graft monitoring.

Methods

A prospective study was conducted at a liver transplantation center in Montpellier, France, involving adult LT recipients who underwent both VCTE and LB within 6 months between January 2022 and January 2024. Protocol LB were performed in the absence of clinical or laboratory evidence of post-LT complications. The primary endpoint was to determine the LSM threshold for predicting abnormal LB. Receiver operating characteristic (ROC) curve analysis and the Youden index were used to identify the optimal cutoff.

Results

Among 90 patients, 32% had abnormal LB findings, including fibrosis ≥ F1 (by Ishak) in 58.6% of abnormal biopsies. The mean LSM was significantly higher in patients with abnormal LB (12.6 ± 13.9 kPa) compared to those with normal LB (5.9 ± 1.6 kPa), p < 0.001. LSM (area under the ROC curve [AUC]: 0.816) was the most accurate predictor of abnormal LB. The optimal LSM threshold to predict abnormal LB was 6.90 kPa (sensitivity [Se] = 0.69, specificity [Sp] = 0.84), while values ≤5.6 kPa and >12.9 kPa respectively ruled out and predicted an abnormal LB.

Conclusion

These results underscore the relevance of VCTE in long-term follow-up of LT recipients to determine the need for LB. VCTE effectively predicts abnormal histology and can guide selective use of protocol liver biopsies, potentially reducing unnecessary procedures. Multicenter studies are needed to validate these findings.

目的银活检（LB）是诊断肝移植后（LT）并发症的金标准。目前，还没有关于振动控制瞬态弹性成像（VCTE）在LT后中长期随访中的价值的数据，与无症状患者的方案LB相比。本研究旨在评估VCTE衍生的肝脏硬度测量（LSM）与LT后5至10年LB方案中观察到的组织学异常之间的相关性，以确定VCTE在长期移植物监测中的潜在作用。方法在法国蒙彼利埃的一家肝移植中心进行了一项前瞻性研究，纳入了2022年1月至2024年1月期间6个月内接受VCTE和LB治疗的成人肝移植受体。在没有肝移植后并发症的临床或实验室证据的情况下进行肝移植。主要终点是确定预测异常LB的LSM阈值。使用受试者工作特征（ROC）曲线分析和约登指数来确定最佳临界值。结果90例患者中，32%的患者LB异常，58.6%的异常活检中纤维化≥F1 （Ishak）。LB异常患者的平均LSM（12.6±13.9 kPa）明显高于LB正常患者（5.9±1.6 kPa）， p < 0.001。ROC曲线下面积（AUC）：预测LB异常的最佳LSM阈值为6.90 kPa（敏感性[Se] = 0.69，特异性[Sp] = 0.84），而≤5.6 kPa和≤12.9 kPa分别排除和预测LB异常。结论这些结果强调了VCTE在肝移植受者长期随访中确定LB需要的相关性。VCTE有效预测异常组织学，可指导选择性使用方案肝活检。可能减少不必要的程序。需要多中心研究来验证这些发现。

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引用次数: 0

The histologic features of severe alcohol-associated hepatitis undergoing liver transplantation: An explant study 重度酒精相关性肝炎肝移植的组织学特征：一项外植体研究

Journal of Liver Transplantation

Pub Date : 2025-12-29 DOI: 10.1016/j.liver.2025.100316

John Grady , Chad Spencer , Michael Idowu , Kevin Houston , Nikita Chadha , Nikki Duong , David Bruno , Joel Wedd , Richard K Sterling

Introduction: Early liver transplantation for severe alcohol-associated hepatitis has been increasingly utilized as a lifesaving treatment option in this population. Despite a more acute presentation, most of these patients have evidence of underlying chronic liver disease. However, detailed descriptions of histologic features in patients with severe alcohol-associated hepatitis undergoing liver transplant are lacking. The aim of this study is to characterize the histologic findings of explanted livers of patients who underwent liver transplantation for severe alcohol-associated hepatitis. Methods: This was a retrospective study of patients who underwent deceased donor liver transplant for severe alcohol-associated hepatitis between 2019–2022 at a single center. Clinical and laboratory data at the time of transplant listing were obtained from the electronic medical record. All explants were reviewed by an expert hepatic pathologist, and histology was assessed for fibrosis staging and microscopic features of alcohol-associated hepatitis. Results: Among 44 patients included in the study, the mean MELD-Na at the time of listing was 37 ± 6. On review of explant histology, 97.7 of patients had cirrhosis. Steatosis was present in 59.1 , Mallory bodies were found in 90.9 , hepatocyte ballooning in 84.1 , lobular inflammation in 95.5 , and megamitochondria in 25 . Portal inflammation was seen in 97.7 of liver explants. Discussion: In this study, all patients who underwent early liver transplant for severe alcohol-associated hepatitis had advanced chronic liver disease on review of explant histology. Although steatosis was only present in 59.1 of explants, most had other classic features of alcohol-associated hepatitis.

早期肝移植治疗严重酒精相关性肝炎在这一人群中越来越多地被用作挽救生命的治疗选择。尽管表现更为急性，但大多数患者有潜在慢性肝病的证据。然而，严重酒精相关性肝炎患者接受肝移植的组织学特征的详细描述是缺乏的。本研究的目的是描述严重酒精相关性肝炎患者接受肝移植后的组织学结果。方法：这是一项回顾性研究，在单一中心对2019-2022年期间因严重酒精相关性肝炎接受已故供肝移植的患者进行回顾性研究。移植登记时的临床和实验室数据来自电子病历。所有外植体均由肝脏病理学专家进行检查，并对酒精相关性肝炎的纤维化分期和显微特征进行组织学评估。结果：纳入研究的44例患者，入组时平均MELD-Na为37±6。经外植体组织学检查，97.7例患者有肝硬化。脂肪变性59.1例，马洛里小体90.9例，肝细胞球囊化84.1例，小叶炎症95.5例，线粒体肥大25例。肝移植体中有97.7例出现门静脉炎症。讨论：在本研究中，所有因严重酒精相关性肝炎而接受早期肝移植的患者在外植体组织学检查中均为晚期慢性肝病。虽然只有59.1的外植体存在脂肪变性，但大多数外植体具有酒精相关性肝炎的其他典型特征。

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引用次数: 0

Cell-free DNA methylation patterns after liver transplantation: a future early, non-invasive, and mechanistic tool to detect liver graft injury and monitor immunosuppression 肝移植后无细胞DNA甲基化模式：一种未来早期、无创、机械的检测肝移植损伤和监测免疫抑制的工具

Journal of Liver Transplantation

Pub Date : 2025-12-21 DOI: 10.1016/j.liver.2025.100315

Filoména Conti , Yvon Calmus

引用次数: 0

The new era in donation after circulatory death in liver transplantation using normothermic machine perfusion 常温机灌注肝移植循环死亡后捐献的新时代

Journal of Liver Transplantation

Pub Date : 2025-12-18 DOI: 10.1016/j.liver.2025.100313

Kenji Okumura, Marco Diaz-Cordova, Abhay Dhand

引用次数: 0

Autologous liver cells mini liver implant for liver cirrhosis treatment: A phase II single center controlled trial 自体肝细胞微型肝植入治疗肝硬化：一项II期单中心对照试验

Journal of Liver Transplantation

Pub Date : 2025-12-17 DOI: 10.1016/j.liver.2025.100314

Hans Ulrich Baer , Andri Sanityoso Sulaiman , Nunuk Tri Wahyuni , Barlian Sutedja , Peter Ian Limas , Olivia Marcelina , Jennifer Lheman , Nuraeni , Clement Drew , Siufui Hendrawan

Background

Liver cirrhosis represents a major healthcare burden, with its prevalence continuing to rise. While orthotopic liver transplantation (OLT) remains to be the only treatment, persistent shortage of donor organ contributes to significant waitlist mortality. Hepatocyte transplantation offers a regenerative approach as a bridging therapy to OLT. However, transplantation through portal vein infusion often ends with poor cell engraftment and allogeneic rejection. Herein, we designed a mini liver implant, composed of a 3-dimensional biodegradable poly-l-lactic acid matrix carrying autologous hepatocyte and islets.

Methods

A phase II clinical trial was conducted in patients with liver cirrhosis to receive either a mini liver implant or standard treatment (control group). Liver stiffness and steatosis were measured by FibroScan® at baseline, 6-, and 12-months after implantation. Child-Pugh score, MELD (Model for End-stage Liver Disease) score, serum albumin, and other biochemical parameters were assessed at baseline, 2-, 4-, 6-, and 12-months.

Results

The implant group demonstrated a progressive reduction in liver stiffness from 19.23 kPa at baseline to 15.33 kPa at 12 months (20.28 % decrease), although not statistically significant. The control group showed worsen liver stiffness from 25.92 kPa to 62.22 kPa (140.05 % increase). Other hepatic parameters, including steatosis, albumin, and liver enzymes, showed no significant differences between groups. The implant was well tolerated with only mild adverse events reported. Overall survival was comparable between both groups.

Conclusions

While larger studies are required to confirm efficacy, autologous mini liver implantation shows promise as a regenerative therapy that could delay or complement liver transplantation.

背景肝硬化是一个主要的医疗负担，其患病率持续上升。虽然原位肝移植（OLT）仍然是唯一的治疗方法，但供体器官的持续短缺导致了大量的等待者死亡率。肝细胞移植提供了一种再生方法，作为OLT的桥接治疗。然而，通过门静脉输注的移植往往以细胞植入不良和异体排斥而告终。在此，我们设计了一个微型肝脏植入物，由三维可生物降解的聚乳酸基质组成，携带自体肝细胞和胰岛。方法在肝硬化患者中进行II期临床试验，分别接受微型肝植入和标准治疗（对照组）。在植入后的基线、6个月和12个月，使用FibroScan®测量肝脏硬度和脂肪变性。Child-Pugh评分、MELD（终末期肝病模型）评分、血清白蛋白和其他生化参数在基线、2个月、4个月、6个月和12个月进行评估。结果植入组肝脏硬度从基线时的19.23 kPa逐渐降低到12个月时的15.33 kPa（降低20.28%），但无统计学意义。对照组肝脏硬度由25.92 kPa加重至62.22 kPa（升高140.05%）。其他肝脏参数，包括脂肪变性、白蛋白和肝酶，组间无显著差异。植入物耐受性良好，仅报告轻微不良事件。两组间的总生存率相当。结论：虽然需要更大规模的研究来证实其有效性，但自体微型肝植入作为一种可延迟或补充肝移植的再生疗法显示出了希望。

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引用次数: 0

The value of albumin-bilirubin (ALBI) score in predicting outcomes following adult living donor liver transplantation 白蛋白胆红素（ALBI）评分在预测成人活体肝移植后预后中的价值

Journal of Liver Transplantation

Pub Date : 2025-12-04 DOI: 10.1016/j.liver.2025.100310

Amal F. Sam , Kavinandan Gangaiah , Stuti Kumari , Premchandar Velusamy , Akila Rajakumar , Dinesh Jothimani , Mohamed Rela

Background

: Albumin-Bilirubin score (ALBI) was primarily developed to quantify the liver function and to prognosticate the patients with hepatocellular carcinoma. Later, it was shown that the ALBI score could predict postoperative complications after liver resection and transplantation.

Methods

: A retrospective analysis was conducted to evaluate the preoperative ALBI score as a predictor of post-living donor liver transplant (LDLT) outcomes. This study included 190 patients from August 2019 to 2021. The predictive power of ALBI for post LDLT outcomes was assessed using Receiver Operating Characteristic (ROC) analysis.

Results

: In total, 190 LDLT recipients were included in this study. Twelve patients (6.3%) belonged to ALBI Grade 1, 82 patients (43.2%) belonged to ALBI Grade 2, and 96 patients (50.5%) belonged to ALBI Grade 3. Similar to the Model for End-stage Liver Disease (MELD), a high ALBI score implies poor liver function, and a low ALBI score implies a better-preserved state. The preoperative ALBI score predicted morbidity with an area under the curve (AUC) of 0.66, whereas the preoperative MELD score predicted morbidity with an AUC of 0.70. For 90-day mortality prediction, preoperative ALBI demonstrated an AUC of 0.60, whereas preoperative MELD showed an AUC of 0.63. ROC curve analysis revealed that the optimal ALBI score cutoff value for differentiating between survivors and non-survivors was -1.40. The discrimination ability of ALBI was higher in patients with high MELD scores (MELD ≥18).

Conclusion

: In predicting both morbidity and 90-day mortality, the performance of the ALBI score was comparable to that of the preoperative MELD. The discriminatory power of ALBI was higher in patients with high MELD scores.

背景：白蛋白-胆红素评分（Albumin-Bilirubin score， ALBI）主要用于量化肝细胞癌患者的肝功能和预后。后来的研究表明，ALBI评分可以预测肝切除移植术后的并发症。方法：回顾性分析评估术前ALBI评分作为活体供肝移植（LDLT）后预后的预测指标。该研究包括2019年8月至2021年的190名患者。使用受试者工作特征（ROC）分析评估ALBI对LDLT后预后的预测能力。结果：本研究共纳入190例LDLT受体。ALBI 1级12例（6.3%），2级82例（43.2%），3级96例（50.5%）。与终末期肝病（MELD）模型类似，高ALBI评分意味着肝功能差，低ALBI评分意味着保存状态较好。术前ALBI评分预测发病率的曲线下面积（AUC）为0.66，而术前MELD评分预测发病率的AUC为0.70。对于90天死亡率预测，术前ALBI的AUC为0.60，而术前MELD的AUC为0.63。ROC曲线分析显示，区分幸存者和非幸存者的最佳ALBI评分截止值为-1.40。MELD评分高（MELD≥18）的患者ALBI的辨别能力较高。结论：在预测发病率和90天死亡率方面，ALBI评分的表现与术前MELD相当。MELD评分高的患者ALBI的歧视力更高。

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引用次数: 0

Validation of Prognostic Accuracy of the RETREAT Score in Hepatocellular carcinoma recurrence after liver transplantation in an Egyptian cohort 在一个埃及队列中肝移植后肝细胞癌复发的撤退评分预后准确性的验证

Journal of Liver Transplantation

Pub Date : 2025-12-04 DOI: 10.1016/j.liver.2025.100312

Reham Ashour , Hazem Mohamed Zakaria , Hossam Soliman , Mona Saeed Tantawy , Sally Waheed Elkhadry , Ahmed Hamdy , Yasmin AbdelRahman Muhammed omar

Background

The Risk Estimation of Tumor Recurrence After Transplant (RETREAT) score has been previously validated as a prognostic model for post-transplant recurrence. Our objective was to establish the validity of the RETREAT score in an Egyptian cohort.

Methods

The study included 113 patients who underwent living donor liver transplantation (LDLT) for Hepatocellular carcinoma (HCC) between 2004 and 2023. RETREAT score effectiveness was investigated following stratification of patients according to Milan criteria (MC) status on the explant pathology. Recurrence risks were assessed using the Kaplan–Meier analysis and differences were calculated with log-rank test.

Results

Over a median follow-up duration of 37 months, the cumulative HCC recurrence rates were 15.4 %, 24.8 %, and 29.5 % at 2, 5, and 10 years, respectively. A strong correlation was demonstrated between higher RETREAT scores and increased recurrence risk. Patients with a RETREAT score ≥ 3 (n = 48) experienced significantly higher recurrence rates at 2, 5, and 10 years than those with a RETREAT score ≤ 2 (n = 65) (35.4 %, 58.8 %, and 70.6 % vs 2.2 % (p < 0.0001)). Based on explant, 74 patients were identified as meeting the MC. The most favorable outcomes were observed in patients who were both within MC and had a low RETREAT score (n = 51), with no HCC recurrence risk being observed at 2, 5, or 10 years.

Conclusion

We validated the predictive accuracy of RETREAT score in HCC recurrence post LT. Patients with low RETREAT scores demonstrated a low risk of HCC recurrence, especially those confirmed to be within MC on explant analysis.

移植后肿瘤复发风险评估（RETREAT）评分先前已被证实为移植后复发的预后模型。我们的目的是在埃及队列中建立RETREAT评分的有效性。方法本研究纳入2004年至2023年间113例肝细胞癌（HCC）患者接受活体肝移植（LDLT）治疗。根据米兰标准（MC）外植体病理状态对患者进行分层后，研究了撤退评分的有效性。复发风险评估采用Kaplan-Meier分析，差异计算采用log-rank检验。结果在37个月的中位随访中，2年、5年和10年的累积HCC复发率分别为15.4%、24.8%和29.5%。较高的撤退评分与复发风险增加之间存在很强的相关性。退却评分≥3的患者（n = 48）在2年、5年和10年的复发率明显高于退却评分≤2的患者（n = 65）（35.4%、58.8%和70.6% vs 2.2% (p < 0.0001)）。基于外植体，74例患者被确定为符合MC。在MC范围内且撤退评分较低的患者（n = 51）中观察到最有利的结果，在2年，5年或10年没有观察到HCC复发风险。结论：我们验证了RETREAT评分对lt后HCC复发的预测准确性。低RETREAT评分的患者HCC复发风险低，尤其是外植体分析证实在MC范围内的患者。

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引用次数: 0

Expanding the donor pool: Outcomes of liver transplantation using grafts with ≥50% macrosteatosis 扩大供体池：大脂肪变性≥50%的肝移植的结果

Journal of Liver Transplantation

Pub Date : 2025-12-04 DOI: 10.1016/j.liver.2025.100311

Kasra Shirini, Shani S. Kamberi, Srinivasan Muthukrishnan, Omar Alattar, Ruchin Patel, Francheska Nieves, Massimo Arcerito, Josue Alvarez-Casas, Saad Malik, Kirti Shetty, Daniel G. Maluf, Chandra Bhati, Raphael P.H. Meier

Liver grafts with over 50% macrosteatosis are often deemed marginal, but organ shortages necessitate exploring their use. We conducted five transplants with deceased donor grafts containing 50%–90% macrosteatosis, ensuring donor age <55 years, CIT ≤6 hours, and recipient laboratory MELD score ≤30. Two patients required reoperations due to thrombotic complications (acute HAT and PVT), and hospital stay ranged from 6 to 26 days. All patients survived beyond one year with functioning grafts. These findings suggest the feasibility of using high-macrosteatosis grafts in intermediate- to low-laboratory-MELD recipients, albeit with potential thrombotic risks.

大脂肪变性超过50%的肝移植通常被认为是边缘性的，但器官短缺需要探索其应用。我们进行了5例移植，死者供体移植中含有50%-90%的大脂肪变性，确保供体年龄55岁，CIT≤6小时，受体实验室MELD评分≤30。2例患者因血栓并发症（急性HAT和PVT）需要再次手术，住院时间从6天到26天不等。所有患者在移植物功能正常的情况下存活超过一年。这些发现表明，尽管存在潜在的血栓风险，但在中低实验室meld受体中使用高大脂肪变性移植物是可行的。

引用次数: 0

A pilot pathway for penicillin allergy delabelling in liver transplant recipients 肝移植受者青霉素过敏去标签的试点途径

Journal of Liver Transplantation

Pub Date : 2025-11-29 DOI: 10.1016/j.liver.2025.100308

Shashank Ramakrishnan , Jeremy S Nayagam , Hannah Kershaw , Marisa Lanzman , Brian J Hogan , Indran Balakrishnan , Alex J Kew , Rachel H Westbrook

Antibiotic allergy labels (AAL), particularly to penicillin, are common among liver transplant (LT) recipients and can compromise antimicrobial stewardship and increase the risk of multidrug-resistant infection. We retrospectively reviewed adult LT recipients over 12 months to determine the prevalence of AAL and antibiotic use, and piloted a pharmacist- and microbiologist-led delabelling pathway for low-risk patients. Among 83 LT recipients, AAL prevalence was 20%, with 12% reporting penicillin allergy and no prior delabelling attempts identified. Patients were screened weekly on a 31-bed hepatopancreaticobiliary ward, and 14 patients (age 35–83 years) were safely delabelled, including nine with liver disease (five of whom were transplant patients). All drug provocation tests were negative and no adverse events occurred. This pilot demonstrates the feasibility and safety of a microbiologist-led penicillin delabelling pathway within a ward based liver transplant programme. To our knowledge, this is the first UK example of such a protocol integrated within a transplant hepatology service, complementing emerging international data supporting antibiotic allergy delabelling in transplant and immunocompromised populations.

抗生素过敏标签（AAL），特别是对青霉素的过敏标签，在肝移植（LT）受者中很常见，可能损害抗菌药物管理并增加耐多药感染的风险。我们回顾性地回顾了12个月以上的成人肾移植受者，以确定AAL和抗生素使用的患病率，并试点了一种由药剂师和微生物学家主导的低风险患者去标签途径。83例肝移植受者中，AAL患病率为20%，其中12%报告青霉素过敏，且未发现先前的撕标签尝试。患者每周在31个床位的肝胆胰病房进行筛查，14名患者（年龄35-83岁）被安全地去标签，包括9名肝病患者（其中5名是移植患者）。所有药物激发试验均为阴性，未发生不良事件。该试验证明了微生物学家主导的青霉素去标签途径在病房肝移植项目中的可行性和安全性。据我们所知，这是英国首例将此类方案整合到移植肝病学服务中的案例，补充了支持移植和免疫功能低下人群中抗生素过敏去标签的新兴国际数据。

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引用次数: 0

A retrospective study of enteral nutrition utilization and clinical outcomes in patients with cirrhosis diagnosed with severe malnutrition 肝硬化合并严重营养不良患者肠内营养利用及临床结果的回顾性研究

Journal of Liver Transplantation

Pub Date : 2025-11-28 DOI: 10.1016/j.liver.2025.100309

Alexandra V Kimchy , Sophia L Dahmani , Sejal G Dave , Molly Good , Salam Sunna , Karen Strenger , Eshetu Tefera , Alex Montero , Rohit Satoskar

Backgrounds/Aims

We evaluated the utilization of enteral feeding and clinical outcomes in hospitalized patients with cirrhosis diagnosed with severe protein calorie malnutrition.

Methods

This was a single center retrospective review of hospitalized patients with cirrhosis from 2019-2023. ICD-10-CM code E43 was used to identity patients with a diagnosis of severe protein calorie malnutrition. Study groups for comparison were patients with and without enteral nutrition support during hospitalization. Wilcoxon rank sum and two sample t-tests were used to examine differences in the averages of continuous variables, and Chi-square and Fisher exact tests were used to investigate differences for categorical variables.

Results

Of the 96 patients with cirrhosis and severe protein calorie malnutrition, 31 patients (32%) received enteral nutrition. Time from admission to initiation of enteral feeding was on average 7 days with a mean total duration of enteral nutrition of 10 days. The comparative analysis showed a significant increase in length of stay, intensive care requirement, bacteremia, gastrointestinal bleeding, discharge MELD 3.0 score and in hospital mortality rates (p ≤ 0.05) among patients who received enteral nutrition.

Conclusions

Less than fifty percent of patients hospitalized with cirrhosis received enteral nutrition despite having a diagnosis of severe protein calorie malnutrition. Initiation of enteral nutrition was found to be delayed a week, on average, after hospital admission. Prolonged length of stay and higher in-hospital mortality rates suggest a lack of benefit of enteral nutrition when started late in the hospital course.

背景/目的：我们评估了诊断为严重蛋白质热量营养不良的肝硬化住院患者肠内喂养的使用情况和临床结果。方法对2019-2023年住院肝硬化患者进行单中心回顾性分析。ICD-10-CM代码E43用于识别诊断为严重蛋白质热量营养不良的患者。比较的研究组为住院期间有无肠内营养支持的患者。使用Wilcoxon秩和和和两个样本t检验来检验连续变量平均值的差异，使用卡方检验和Fisher精确检验来研究分类变量的差异。结果96例肝硬化合并严重蛋白热量营养不良患者中，31例（32%）接受肠内营养。入院至开始肠内营养平均时间为7天，平均总肠内营养持续时间为10天。对比分析显示，肠内营养组患者的住院时间、重症监护需求、菌血症、胃肠道出血、出院MELD 3.0评分及院内死亡率均显著增加（p≤0.05）。结论：不到50%的肝硬化住院患者接受了肠内营养，尽管他们被诊断为严重的蛋白质卡路里营养不良。发现肠内营养的开始平均延迟一周，在入院后。住院时间的延长和较高的住院死亡率表明，在住院过程中较晚开始肠内营养缺乏益处。

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引用次数: 0