Early prognosis judgment in adult recipients after first liver transplantation

• DOI: 10.3760/cma.j.issn.1673-9752.2012.06.013
• Publication Date: 2012-12-20
• Authors: Yong-fa Tan; Jie Zhou; Kai T; Qi-fan Zhang; Sheng Zhang; Zhenchao Luo; Liyan Chen
• Keywords: Prothrombin time; Univariate analysis

Objective To judge the prognosis of adult recipients after first liver transplantation by stepwise discriminant analysis,and screen out main influencing factors.Methods The clinical data 221 patients who received at Nanfang Hospital Southern Medical University were retrospectively analyzed.A total 218 met criteria divided into training samples (188 admitted from August 2004 to June 2010) and checking (30 July 2010 February 2011),and then all re-divided dead group (survival time ≤ 90 days,34 patients) surviving ＞ days,184 patients).Factors which had significant difference univariate analysis was further analyzed method.All t test,rank sum test,chi-square test or Fisher exact probability test.Results ages in living (54 ± 11)years (51 11)years,respectively,with no between 2 groups (t =-1.681,P 0.05).The preoperative levels hemoglobin 106.7 g/L 119.2 g/L,respectively,with a =2.809,P ＜ 0.05).There differences serum creatinine,urea nitrogen,albumin,total bilirubin,indirect bilirubin,Na+,prothrombin time,activated partial thromboplastin time,international normalized ratio,fibrinogen,prothrombin activity,platelet,nutrition risk index,model for end-stage disease score,number with hepatic encephalopathy (HE),preoperative hepatorenal syndrome (HRS),preoperative digestive tract bleeding,preoperative infection,preoperative diabetes,Child-Turcotte-Pugh score,cardiac function classification anesthesia rating operation time,anhepatic time,volume intraoperative blood transfusion,volume peritoneal effusion ; urine output,between (Z =-2.277,-2.595,-3.290,-3.486,-2.562,-2.577,-3.670,-3.882,-3.625,-3.557,-3.837,-1.974,-3.693,-3.815,x2 =19.632,9.756,28.143,Z =-4.175,-3.905,-4.865,-3.564,-5.822,P 0.05).Preoperative HE,preoperative HRS,duration operation,intraoperative transfusion volume independent factors early transplantation.The standardized regression coefficients 0.146,0.188,0.257,0.181,-0.340,89.9％ (169/188) 90.0％ (27/30) correctly classified.Conclusion Based on including HRS,HE,intraoperative transfusion,intraoperative duration operation,the can be judged transplantation.

Key words: Liver transplantation; Early prognosis; Stepwise analysis; Hepatorenal ; Hepatic