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001-es BibID:	BIBFORM064137
Első szerző:	Nemes Balázs Áron (sebész)
Cím:	Outcome of Liver Transplantation Based on Donor Graft Quality and Recipient Status / B. Nemes, F. Gelley, G. Zádori, L. Piros, J. Perneczky, L. Kóbori, I. Fehérvári, D. Görög
Dátum:	2010
ISSN:	0041-1345
Megjegyzések:	Background. Availability of suitable donor organs has always limited the number of livertransplantations performed. Use of marginal donor organs is an alternative to overcomeorgan shortage.Objective. To analyze the effect of various combinations of donor organ quality andrecipient status on the outcome of liver transplantation.Materials and Methods. Data from 260 whole-liver transplantations performed betweenJanuary 2003 and September 2009 were analyzed retrospectively. Study groups wereestablished according to donor organ quality (marginal score 0?1 vs 2?5) and recipientstatus (Model for End-Stage Liver Disease [MELD] score 17 or 17). In patients at lowrisk, 102 received optimal grafts (good-to-good group [G/G], and 75 received marginalgrafts (bad-to-good group [B/G]. In patients at high risk, 46 received optimal grafts(good-to-bad group [G/B], and 37 received marginal grafts (bad-to-bad group [B/B].Results. No differences were observed in cumulative patient and graft survival rates;however, total survival differed in the early period after transplantation, that is, within 1year. There was a higher rate of overall postoperative complications including initial poorgraft function, bleeding, infection, and kidney failure in group B/B compared with groupG/B (25 of 37 patients [67.5%] vs 27 of 46 patients [59.0%]), group B/G (25 of 37 patients[68%] vs 39 of 75 patients [52%], and group G/G (25 of 37 patients [68%] vs 43 of 102patients [42%]) (P.04). Patients with a high MELD score (G/B and B/B) demonstratedincreased risk of postoperative complications. Use of donor organs with marginal score of2 or higher in patients with high MELD scores increased early patient mortality.Conclusion. In summary, patients with a high MELD score (G/B and B/B) are at anincreased risk of post-OLT complications. In contrast, use of marginal grafts (B/G andB/B) increased the rate of hepatitis C virus recurrence and decreased the response rate toantiviral therapy. The combination of impaired donor grafts and recipients at high riskshould be avoided.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Transplantation Proceedings. - 42 : 6 (2010), p. 2327-2330. -
További szerzők:	Gelley Fanni Zádori Gergely (1983-) (sebész) Piros László Perneczky J. Kóbori László Fehérvári Imre Görög Dénes
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