一项基于调查的国际多中心急性肝衰竭诊治分析。

IF 4.7 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Liver Transplantation Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI:10.1097/LVT.0000000000000402
Ahmet Gurakar, Isabel Conde Amiel, N Begum Ozturk, Florent Artru, Nazia Selzner, Kevin J Psoter, Joanna C Dionne, Constantine Karvellas, Akila Rajakumar, Fuat Saner, Ram M Subramanian, Li-Ying Sun, Anil Dhawan, Audrey Coilly
{"title":"一项基于调查的国际多中心急性肝衰竭诊治分析。","authors":"Ahmet Gurakar, Isabel Conde Amiel, N Begum Ozturk, Florent Artru, Nazia Selzner, Kevin J Psoter, Joanna C Dionne, Constantine Karvellas, Akila Rajakumar, Fuat Saner, Ram M Subramanian, Li-Ying Sun, Anil Dhawan, Audrey Coilly","doi":"10.1097/LVT.0000000000000402","DOIUrl":null,"url":null,"abstract":"<p><p>Acute liver failure (ALF) is an acute liver dysfunction with coagulopathy and HE in a patient with no known liver disease. As ALF is rare and large clinical trials are lacking, the level of evidence regarding its management is low-moderate, favoring heterogeneous clinical practice. In this international multicenter survey study, we aimed to investigate the current practice and management of patients with ALF. An online survey targeting physicians who care for patients with ALF was developed by the International Liver Transplantation Society ALF Special-Interest Group. The survey focused on the management and liver transplantation (LT) practices of ALF. Survey questions were summarized overall and by geographic region. A total of 267 physicians completed the survey, with a survey response rate of 21.36%. Centers from all continents were represented. More than 90% of physicians specialized in either transplant hepatology/surgery or anesthesiology/critical care. Two hundred fifty-two (94.4%) respondents' institutions offered LT. A total of 76.8% of respondents' centers had a dedicated liver-intensive or transplant-intensive care unit ( p < 0.001). The median time to LT was within 48 hours in 12.7% of respondents' centers, 72 hours in 35.6%, 1 week in 37.6%, and more than 1 week in 9.6% ( p < 0.001). Deceased donor liver graft (49.6%) was the most common type of graft offered. For consideration of LT, 84.8% of physicians used King's College Criteria, and 41.6% used Clichy Criteria. Significant differences were observed between Asia, Europe, and North America for offering LT, number of LTs performed, volume of patients with ALF, admission to a dedicated intensive care unit, median time to LT, type of liver graft, monitoring HE and intracranial pressure, management of coagulopathy, and utilization of different criteria for LT. In our study, we observed significant geographic differences in the practice and management of ALF. As ALF is rare, multicenter studies are valuable for identifying global practice.</p>","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"1217-1225"},"PeriodicalIF":4.7000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An international, multicenter, survey-based analysis of practice and management of acute liver failure.\",\"authors\":\"Ahmet Gurakar, Isabel Conde Amiel, N Begum Ozturk, Florent Artru, Nazia Selzner, Kevin J Psoter, Joanna C Dionne, Constantine Karvellas, Akila Rajakumar, Fuat Saner, Ram M Subramanian, Li-Ying Sun, Anil Dhawan, Audrey Coilly\",\"doi\":\"10.1097/LVT.0000000000000402\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Acute liver failure (ALF) is an acute liver dysfunction with coagulopathy and HE in a patient with no known liver disease. As ALF is rare and large clinical trials are lacking, the level of evidence regarding its management is low-moderate, favoring heterogeneous clinical practice. In this international multicenter survey study, we aimed to investigate the current practice and management of patients with ALF. An online survey targeting physicians who care for patients with ALF was developed by the International Liver Transplantation Society ALF Special-Interest Group. The survey focused on the management and liver transplantation (LT) practices of ALF. Survey questions were summarized overall and by geographic region. A total of 267 physicians completed the survey, with a survey response rate of 21.36%. Centers from all continents were represented. More than 90% of physicians specialized in either transplant hepatology/surgery or anesthesiology/critical care. Two hundred fifty-two (94.4%) respondents' institutions offered LT. A total of 76.8% of respondents' centers had a dedicated liver-intensive or transplant-intensive care unit ( p < 0.001). The median time to LT was within 48 hours in 12.7% of respondents' centers, 72 hours in 35.6%, 1 week in 37.6%, and more than 1 week in 9.6% ( p < 0.001). Deceased donor liver graft (49.6%) was the most common type of graft offered. For consideration of LT, 84.8% of physicians used King's College Criteria, and 41.6% used Clichy Criteria. Significant differences were observed between Asia, Europe, and North America for offering LT, number of LTs performed, volume of patients with ALF, admission to a dedicated intensive care unit, median time to LT, type of liver graft, monitoring HE and intracranial pressure, management of coagulopathy, and utilization of different criteria for LT. In our study, we observed significant geographic differences in the practice and management of ALF. As ALF is rare, multicenter studies are valuable for identifying global practice.</p>\",\"PeriodicalId\":18072,\"journal\":{\"name\":\"Liver Transplantation\",\"volume\":\" \",\"pages\":\"1217-1225\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Liver Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/LVT.0000000000000402\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Liver Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/LVT.0000000000000402","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/23 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

简介急性肝功能衰竭(ALF)是一种急性肝功能失调,伴有凝血功能障碍和肝性脑病,患者无已知肝病。由于 ALF 非常罕见且缺乏大型临床试验,有关其治疗的证据水平处于中低水平,导致临床实践各不相同。在这项国际多中心调查研究中,我们旨在调查 ALF 患者目前的治疗方法和管理情况:方法:国际肝脏移植协会 ALF 特别兴趣小组针对护理 ALF 患者的医生开展了一项在线调查。调查的重点是 ALF 的管理和肝移植 (LT) 实践。调查结果:共有 267 名医生完成了调查,调查回复率为 21.36%。来自各大洲的中心都参与了调查。90%以上的医生擅长移植肝病学/外科或麻醉学/重症监护。有 252 家(94.4%)受访机构提供 LT。76.8%的受访机构设有专门的肝脏或移植重症监护病房(讨论):在我们的研究中,我们观察到在 ALF 的实践和管理方面存在明显的地域差异。由于ALF非常罕见,因此多中心研究对于确定全球实践非常有价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
An international, multicenter, survey-based analysis of practice and management of acute liver failure.

Acute liver failure (ALF) is an acute liver dysfunction with coagulopathy and HE in a patient with no known liver disease. As ALF is rare and large clinical trials are lacking, the level of evidence regarding its management is low-moderate, favoring heterogeneous clinical practice. In this international multicenter survey study, we aimed to investigate the current practice and management of patients with ALF. An online survey targeting physicians who care for patients with ALF was developed by the International Liver Transplantation Society ALF Special-Interest Group. The survey focused on the management and liver transplantation (LT) practices of ALF. Survey questions were summarized overall and by geographic region. A total of 267 physicians completed the survey, with a survey response rate of 21.36%. Centers from all continents were represented. More than 90% of physicians specialized in either transplant hepatology/surgery or anesthesiology/critical care. Two hundred fifty-two (94.4%) respondents' institutions offered LT. A total of 76.8% of respondents' centers had a dedicated liver-intensive or transplant-intensive care unit ( p < 0.001). The median time to LT was within 48 hours in 12.7% of respondents' centers, 72 hours in 35.6%, 1 week in 37.6%, and more than 1 week in 9.6% ( p < 0.001). Deceased donor liver graft (49.6%) was the most common type of graft offered. For consideration of LT, 84.8% of physicians used King's College Criteria, and 41.6% used Clichy Criteria. Significant differences were observed between Asia, Europe, and North America for offering LT, number of LTs performed, volume of patients with ALF, admission to a dedicated intensive care unit, median time to LT, type of liver graft, monitoring HE and intracranial pressure, management of coagulopathy, and utilization of different criteria for LT. In our study, we observed significant geographic differences in the practice and management of ALF. As ALF is rare, multicenter studies are valuable for identifying global practice.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Liver Transplantation
Liver Transplantation 医学-外科
CiteScore
7.40
自引率
6.50%
发文量
254
审稿时长
3-8 weeks
期刊介绍: Since the first application of liver transplantation in a clinical situation was reported more than twenty years ago, there has been a great deal of growth in this field and more is anticipated. As an official publication of the AASLD, Liver Transplantation delivers current, peer-reviewed articles on liver transplantation, liver surgery, and chronic liver disease — the information necessary to keep abreast of this evolving specialty.
期刊最新文献
Management of the liver transplant candidate with high cardiac risk: Multidisciplinary best practices and recommendations. An international, multicenter, survey-based analysis of practice and management of acute liver failure. Utility of scores to predict alcohol use after liver transplant: Take them with a grain of salt. Intensive locoregional therapy before liver transplantation for colorectal cancer liver metastasis: A novel pretransplant protocol. Association of psychosocial risk factors and liver transplant evaluation outcomes in metabolic dysfunction-associated steatotic liver disease.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1