|
|
Glasgow coma scale and APACHE-II scores affect the liver transplantation outcomes in patients with acute liver failure |
Necdet Guler, Omer Unalp, Ayse Guler, Onur Yaprak, Murat Dayangac, Murat Sozbilen, Murat Akyildiz and Yaman Tokat |
Istanbul, Turkey
Author Affiliations: Organ Transplantation Center, Sisli Florence Nightingale Hospital, Istanbul, Turkey (Guler N, Yaprak O, Dayangac M, Akyildiz M and Tokat Y); Departments of General Surgery (Unalp O and Sozbilen M) and Neurology (Guler A), Ege University Medical School, Izmir, Turkey; Department of Gastroenterology, Istanbul Bilim University, Medical School, Istanbul, Turkey (Akyildiz M)
Corresponding Author: Murat Akyildiz, MD, Organ Transplantation Center, Sisli Florence Nightingale Hospital, Istanbul, Turkey (Tel: 90-533-2402104; Email: akyildizmr@yahoo.com) |
|
|
Abstract BACKGROUND: The timing and selection of patients for liver transplantation in acute liver failure are great challenges. This study aimed to investigate the effect of Glasgow coma scale (GCS) and APACHE-II scores on liver transplantation outcomes in patients with acute liver failure.
METHOD: A total of 25 patients with acute liver failure were retrospectively analyzed according to age, etiology, time to transplantation, coma scores, complications and mortality.
RESULTS: Eighteen patients received transplants from live donors and 7 had cadaveric whole liver transplants. The mean duration of follow-up after liver transplantation was 39.86±40.23 months. Seven patients died within the perioperative period and the 1-, 3-, 5-year survival rates of the patients were 72%, 72% and 60%, respectively. The parameters evaluated for the perioperative deaths versus alive were as follows: the mean age of the patients was 33.71 vs 28 years, MELD score was 40 vs 32.66, GCS was 5.57 vs 10.16, APACHE-II score was 23 vs 18.11, serum sodium level was 138.57 vs 138.44 mmol/L, mean waiting time before the operation was 12 vs 5.16 days. Low GCS, high APACHE-II score and longer waiting time before the operation (P<0.01) were found as statistically significant factors for perioperative mortality.
CONCLUSION: Lower GCS and higher APACHE-II scores are related to poor outcomes in patients with acute liver failure after liver transplantation.
|
|
|
|
|
|
|
|