急性肝功能衰竭患者原位肝移植术后的存活分析  

Survival analysis of patients with acute liver failure after liver transplantation

作　　者：王兴强[1] 刘懿禾[1] 于立新[1] 孙雁[1] 沈中阳[1] Wang Xingqiang;Liu Yihe;Yu Lixin;Sun Yan;Sheng Zhongyang(Department of Transplantation,First Central Municipal Hospital,Key Laboratory for Critical Care Medicine of Ministry of Health,Municipal Key Laboratory for Organ Transplantation,Municipal Clinical Research Center for Organ Transplantation,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院移植科,卫生部危重病急救医学重点实验室,天津市器官移植重点实验室,天津市器官移植临床医学研究中心,300192

出　　处：《中华器官移植杂志》2019年第11期679-682,共4页Chinese Journal of Organ Transplantation

基　　金：天津市科技计划项目(14RCGFSY00147);国家国际科技合作专项项目(2015DFG31850)。

摘　　要：目的探讨原位肝移植术治疗急性肝功能衰竭患者的临床疗效和术后死亡的危险因素。方法回顾性分析2012年1月至2017年12月间31例因急性肝功能衰竭接受原位肝移植术受者的临床资料,收集所有受者的住院资料和随访信息。单因素生存分析采用Kaplan-Meier法进行Log-rank检验,多因素生存分析采用Cox比例风险模型。结果单因素分析结果显示,受者移植时年龄≥55岁,术前合并肝肾综合征(HRS),术前合并感染,术前未使用分子吸附再循环系统(MARS)支持,以及术后发生感染是影响受者术后生存的危险因素(P<0.05);多因素分析显示,术前合并感染是影响肝移植受者术后存活的独立危险因素(P<0.01)。结论原位肝移植治疗急性肝功能衰竭的效果明确,术前感染是影响受者术后存活的独立危险因素。Objective To explore the clinical efficacy and risk factors of mortality for liver transplantation in patients with acute liver failure.Methods From January 2012 to December 2017,retrospective analysis was performed for 31 patients with acute liver failure undergoing orthotopic liver transplantation.Clinical data and follow-up data were recorded.Univariate survival analysis was performed by Kaplan-Meier and Log-rank tests while multivariate survival analysis conducted by proportional hazards model.Results Age≥55 years,preoperative hepatorenal syndrome,perioperative infection and preoperative non-molecular adsorbent recirculating system(MARS)support were influencing factors of postoperative survival rate by univariate survival analysis(P<0.05).Preoperative infection was an independent risk factor for survival after liver transplantation by multivariate COX regression analysis(P<0.01).Conclusions Liver transplantation is an effective treatment for acute liver failure.And preoperative infection is an independent risk factor for survival after liver transplantation.

关 键 词：肝功能衰竭 急性 肝移植 生存分析 

分 类 号：R657[医药卫生—外科学]