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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.2
- 발행연도
- 2020.2
- 수록면
- 102 - 109 (8page)
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초록· 키워드
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Purpose: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years.
Methods: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT).
Results: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%.
Conclusion: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.
Methods: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT).
Results: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%.
Conclusion: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (29)
참고문헌 신청
R.Randal Bollinger / 2004 / Organ Allocation for Transplantation in the USA and Korea: The Changing Roles of Equity and Utility / Yonsei Medical Journal 45(6):1035~1042
Hwang S / 2013 / Survival rates among patients awaiting deceased donor liver transplants at a single highvolume Korean center / Transplant Proc 45:2995~2996
Min SI / 2015 / To achieve national selfsufficiency : recent progresses in deceased donation in Korea / Transplantation 99:765~770
Lee SG / 2015 / Liver transplantation in Korea : past, present, and future / Transplant Proc 47:705~708
Jung BH / 2015 / Updated status of deceased-donor liver graft allocation for high-urgency adult patients in a Korean high-volume liver transplantation center / Transplant Proc 47:580~583
Hwang S / 2013 / Survival rates among patients awaiting deceased donor liver transplants at a single highvolume Korean center / Transplant Proc 45:2995~2996
Min SI / 2015 / To achieve national selfsufficiency : recent progresses in deceased donation in Korea / Transplantation 99:765~770
Lee SG / 2015 / Liver transplantation in Korea : past, present, and future / Transplant Proc 47:705~708
Jung BH / 2015 / Updated status of deceased-donor liver graft allocation for high-urgency adult patients in a Korean high-volume liver transplantation center / Transplant Proc 47:580~583
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UCI(KEPA) : I410-ECN-0101-2020-514-000365569