114例等待肝移植的急性肝衰竭患者的支持性体外治疗包括血浆置换和持续静脉静脉血液滤过的15年回顾性研究。

IF 1.1 4区 医学 Q3 SURGERY Annals of Transplantation Pub Date : 2023-06-27 DOI:10.12659/AOT.939745
Ilhan Ocak
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引用次数: 0

摘要

最近,有研究建议对急性肝衰竭患者联合使用体外支持治疗,特别是血浆置换和持续静脉静脉血液滤过。这项为期15年的回顾性研究旨在评估114例等待肝移植的急性肝衰竭患者的支持性体外治疗,包括血浆置换和持续静脉静脉血液滤过。材料与方法回顾性分析1288例接受肝移植的成人患者和161例接受替代治疗的成人患者的病历;114例接受联合体外支持治疗的急性肝衰竭患者纳入研究。比较治疗前后生化实验室数据。结果男性50例,女性64例。第一组34例患者经肝移植术后恢复,4例患者在肝移植术后1年内死亡。第二组(80例)66例患者未行肝移植康复,14例患者在治疗后2周内死亡。所有患者在停止体外支持治疗后血清肝功能(谷丙转氨酶、天冬氨酸转氨酶和总胆红素)、氨和凝血酶原时间/国际标准化比率均显著降低(P
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A 15-Year Retrospective Study of Supportive Extracorporeal Therapies Including Plasma Exchange and Continuous Venovenous Hemodiafiltration of 114 Adults with Acute Liver Failure Awaiting Liver Transplantation.

BACKGROUND Recently, there has been a recommendation to utilize a combination of supportive extracorporeal therapies, specifically plasma exchange and continuous venovenous hemodiafiltration, in patients with acute liver failure. This 15-year retrospective study aimed to evaluate supportive extracorporeal therapy, including plasma exchange and continuous venovenous hemodiafiltration, for 114 adults with acute liver failure awaiting liver transplant. MATERIAL AND METHODS In this retrospective study, the medical records of 1288 adult patients who underwent liver transplantation and 161 adult patients who received alternative therapy were analyzed; 114 patients who received combined supportive extracorporeal therapy for acute liver failure were included in the study. Biochemical laboratory data were compared before and after therapy. RESULTS The study included 50 male and 64 female patients. The first group (34 patients) recovered with liver transplantation, and 4 patients died in the first year after liver transplantation. In the second group (80 patients), 66 patients recovered without liver transplantation, while 14 patients died within the first 2 weeks after therapy. All patients showed significant reductions in serum hepatic function tests (alanine transaminase, aspartate transaminase, and total bilirubin), ammonia, and prothrombin time/international normalized ratio after discontinuation of combined supportive extracorporeal therapy (P<0.01). There was also a significant improvement in the hemodynamic parameter. CONCLUSIONS This combined extracorporeal therapy can be used as a supportive treatment for both recovery and bridge to liver transplantation in patients with acute liver failure. In addition, treatment can be continued until liver regeneration and until a usable donor is found.

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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
79
审稿时长
>12 weeks
期刊介绍: Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation. Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time to first decision is around 3-4 weeks. Time to publication of accepted manuscripts continues to be shortened, with the Editorial team committed to a goal of 3 months from acceptance to publication. Expert reseachers and clinicians from around the world contribute original Articles, Review Papers, Case Reports and Special Reports in every pertinent specialty, providing a lot of arguments for discussion of exciting developments and controversies in the field.
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