التفاصيل البيبلوغرافية
| العنوان: |
Liver transplantation in critically ill patients: Preoperative predictive factors of post-transplant mortality to avoid futility. |
| المؤلفون: |
Michard, Baptiste1,2 baptiste.michard@chru-strasbourg.fr, Artzner, Thierry1,2, Lebas, Benjamin1,2, Besch, Camille3, Guillot, Max1,4, Faitot, François2,3, Lefebvre, François5, Bachellier, Philippe2,3, Castelain, Vincent1,2, Maestraggi, Quentin1,2, Schneider, Francis1,2,6 |
| المصدر: |
Clinical Transplantation. Dec2017, Vol. 31 Issue 12, pn/a-N.PAG. 8p. |
| مصطلحات موضوعية: |
*LIVER transplantation, *CRITICALLY ill, *LIVER failure, *PREOPERATIVE care, *INTENSIVE care units, *ADULT respiratory distress syndrome, *DEATH rate, *PATIENTS |
| مستخلص: |
Background The allocation of liver transplants to patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) with multi-organ failure who are admitted in ICU remains controversial due to their high post-transplant mortality rate and the absence of identified mortality risk factors. Methods We performed a single-center retrospective cohort study to determine the post-transplant mortality rate of patients with ALF and ACLF requiring ICU care prior to liver transplant (LT) and identified pretransplant factors of post-transplant mortality. Results Eighty-four patients (29 with ALF and 55 with ACLF) received a liver transplant while they were hospitalized at the ICU. Their mean model for end-stage liver disease (MELD) score was 41, and their mean sequential organ failure assessment (SOFA) was 15 the day before transplant. The overall 1-year survival rate was 66%. In multivariate analysis, pretransplant lactate level and acute respiratory distress syndrome (ARDS) were the only two independent factors associated with post-transplant mortality. The absence of ARDS and a pretransplant lactate level< 5 mmol/L led to the identification of a subgroup of ICU patients with a good 1-year post-transplant survival (>80%). Conclusions Low lactatemia lactate level and the absence of ARDS could be useful criteria in selecting those patients in ICU who could be eligible for liver transplant. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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