Annals of Transplantation最新文献

{"title":"Survival Analysis of Liver Transplants in Patients with Acute Liver Failure from Acetaminophen and Mushroom Toxicity.","authors":"Emilia Kruk, Maciej Krasnodębski, Paweł Rykowski, Wojciech Figiel, Wacław Hołówko, Joanna Raszeja-Wyszomirska, Michał Grąt","doi":"10.12659/AOT.946485","DOIUrl":"https://doi.org/10.12659/AOT.946485","url":null,"abstract":"<p><p>BACKGROUND Acute liver failure (ALF) remains a critical concern, accounting for about 8% of all liver transplants, with acetaminophen overdose contributing to nearly half of these cases. Besides synthetic toxins, natural toxins such as phallotoxin from Amanita phalloides mushrooms also lead to severe hepatocyte damage. This study investigates the outcomes of liver transplantation (LT) as a life-saving intervention in patients suffering from ALF due to acetaminophen and Amanita phalloides poisoning. MATERIAL AND METHODS We conducted a retrospective analysis of 39 patients who underwent LT for ALF induced by acetaminophen (n=18) or A. phalloides (n=21) poisoning at the Medical University of Warsaw. Various statistical analyses, including logistic regression, Mann-Whitney-U, and chi-squared tests, were employed. Survival rates were determined using Kaplan-Meier analysis. RESULTS The cohort included 24 females and 15 males, with a median age of 41. The 90-day mortality rate was 22.2% for acetaminophen poisoning and 38.1% for A. phalloides poisoning (P=0.284), with an estimated 5-year survival rate of 59.6%. Key factors associated with increased 90-day mortality included the number of red blood cells transfused (OR 1.574 per unit; P=0.011), fresh frozen plasma units (OR 1.346 per unit; P=0.003), acute kidney failure requiring hemodialysis (OR 13.50; P=0.021), and days from listing to LT (OR 2.289 per day; P=0.013). CONCLUSIONS Liver transplantation for ALF, though inherently high-risk, offers substantial survival benefits. Outcomes are largely influenced by the patient's condition at the time of transplant, organ availability, and intraoperative management. Despite significant mortality risks, LT remains a crucial intervention for ALF due to acetaminophen and Amanita phalloides toxicity.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946485"},"PeriodicalIF":1.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Routine Immunity Score (RIS2020) to Predict Severe Infection in Solid-Organ Transplant Recipients.","authors":"Elizabeth Sarmiento, Ikram Ezzahouri, Maricela Jimenez-Lopez, Kristofer M Limay Carré, Rocio Alonso, Carlos Ortiz-Bautista, Magdalena Salcedo Plaza, Maria Luisa Rodríguez-Ferrero, Pedro Martin Padilla-Machaca, Ana Cerron, Jose Carlos Chaman, Ana P Vionnet Salvo, Javier Carbone","doi":"10.12659/AOT.946233","DOIUrl":"10.12659/AOT.946233","url":null,"abstract":"<p><p>BACKGROUND Infection is a cause of morbidity and mortality in solid-organ transplantation (SOT). We evaluated a new score that is applied during the first month after transplantation. The score comprises biomarkers of innate and acquired immunity to predict infections in SOT. MATERIAL AND METHODS Prospectively collected blood samples from 377 heart, liver, or kidney recipients were analyzed at 2 centers in Madrid (Spain) and Lima (Peru). Biomarkers were tested before transplantation and at days 7 and 30 after transplantation. During the first 6 months after transplantation, 183 (48.5%) patients developed severe infections (bacterial infections and/or CMV disease). Risk for severe infection was assessed using logistic regression analysis. We designed a score, the routine immunity score (RIS2020), which is based on the sum of the hazard ratios (HRs) of each biomarker. RESULTS The risk factors for severe infection were as follows: Moderate IgG hypogammaglobulinemia (IgG <600 mg/dL at days 7 or 30, HR 2.07, 95% CI 1.37-3.12, p=0.0005, 2 points), CD4 <400 cells/uL at day 30 (HR 1.76, 95% CI 1.03-3.04, p=0.039, 2 points), C3 <80 mg/dL at day 30 (HR 2.18, 95%CI 1.16-4.06, p=0.014, 2 points), and CRP >3 mg/dL at day 30 (HR 2.11, 95% CI 1.12-3.97, p=0.02, 2 points). In patients with ≥4 points, the HR for infection was 5.18 (95% CI 3.06-8.75; p<0.001). RIS2020 was an independent predictor of severe infection in multivariate models. CONCLUSIONS An immunological score combining moderate IgG hypogammaglobulinemia and other parameters of innate and acquired immunity could better identify the risk for severe infection in SOT.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946233"},"PeriodicalIF":1.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living Donor Liver Transplantation with Small Left Lobe Grafts: Prospective Validation of Utility of Splenectomy in Selected Recipients.","authors":"Hajime Matsushima, Akihiko Soyama, Takanobu Hara, Takashi Hamada, Yuta Kawaguchi, Kazushige Migita, Ayaka Satoh, Yamashita Mampei, Hajime Imamura, Ayaka Kinoshita, Tomohiko Adachi, Susumu Eguchi","doi":"10.12659/AOT.946374","DOIUrl":"10.12659/AOT.946374","url":null,"abstract":"<p><p>BACKGROUND We previously reported that the Model for End-stage Liver Disease (MELD) score and donor age are risk factors for small-for-size syndrome in adult living donor liver transplantation (LDLT) involving small grafts. Since April 2021, we have performed splenectomy as a portal inflow modulation in LDLT using small grafts according to the presence of risk factors. In this study, we evaluated the validity of our splenectomy strategies for optimizing graft outcomes. MATERIAL AND METHODS We retrospectively reviewed patients who underwent primary LDLT using left lobe grafts with the middle hepatic vein from January 2005 to January 2024 at our institution. We also compared the graft outcomes between recipients who underwent LDLT beginning in April 2021 (current policy group) and those who underwent LDLT in the era when splenectomy as portal modulation was not indicated (previous policy group). RESULTS In total, 173 consecutive LDLTs (current policy group: n=15) involving left lobe grafts were analyzed. Splenectomy was performed in 9 of 15 (60.0%) patients in the current policy group. All 15 patients in the current policy group remained alive for a median follow-up of 20.5 months. The rate of early allograft dysfunction was significantly lower, and the rate of small-for-size syndrome tended to be lower in the current policy group than in the previous policy group (13.3% vs 39.2%, P=0.047 and 20.0% vs 36.1%, P=0.211, respectively). CONCLUSIONS LDLT with splenectomy for high-risk patients may expand the availability of small left lobe grafts and optimize graft outcomes.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946374"},"PeriodicalIF":1.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial Reconstruction Using the Right Gastroepiploic Artery in Living Donor Liver Transplantation: A Single-Center Experience.","authors":"Takanobu Hara, Akihiko Soyama, Hajime Matsushima, Takashi Hamada, Ayaka Kinoshita, Hajime Imamura, Mampei Yamashita, Ayaka Satoh, Kazushige Migita, Yuta Kawaguchi, Tomohiko Adachi, Mitsuhisa Takatsuki, Susumu Eguchi","doi":"10.12659/AOT.946135","DOIUrl":"10.12659/AOT.946135","url":null,"abstract":"<p><p>BACKGROUND Recipient hepatic arteries are generally used for arterial reconstructions in living donor liver transplantation. When the hepatic arteries are not feasible, the right gastroepiploic artery is one of the options for arterial reconstructions. In this study, we evaluate the feasibility of using the right gastroepiploic artery and report the analyzed retrospective patient outcomes. MATERIAL AND METHODS We included 324 patients who underwent primary living donor liver transplantation between August 1997 and December 2023. The rates of complications and surgical outcomes for different arteries used for reconstruction were compared between the groups. RESULTS For primary arterial reconstruction, the right gastroepiploic artery was used in 18 patients. The incidence of arterial complications and biliary strictures was higher than in the remaining 306 patients (P=0.01 and P=0.21, respectively). The 1-year and 5-year graft survival rates were 83.3% and 77.8% in the right gastroepiploic artery group, and 83.7% and 70.1% in the hepatic artery group, respectively (P=0.58). Eleven patients underwent arterial re-reconstruction secondary to arterial complications. The right gastroepiploic artery was used for the first time in 7 of these patients because the hepatic arteries were not reusable. Arterial complications after arterial re-reconstruction occurred in 4 patients (36.4%). CONCLUSIONS Arterial reconstruction using the right gastroepiploic artery was an effective option when the hepatic arteries were not suitable options, as it offered graft outcomes comparable to those of hepatic artery reconstruction, despite an increased risk of arterial and biliary complications.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946135"},"PeriodicalIF":1.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Graft Loss Risk in Living-Donor Kidney Transplants with Multiple Renal Arteries.","authors":"Kuniaki Inoue, Shunta Hori, Mitsuru Tomizawa, Tatsuo Yoneda, Yasushi Nakai, Makito Miyake, Nobumichi Tanaka, Kiyohide Fujimoto","doi":"10.12659/AOT.946489","DOIUrl":"10.12659/AOT.946489","url":null,"abstract":"<p><p>BACKGROUND Despite its surgical complexity, kidney transplantation (KT) with multiple renal arteries (MRA) is comparable in performance to KT with a single renal artery (SRA). This study aimed to evaluate the effect of MRA and to investigate risk factors for graft loss in living-donor KT with MRA. MATERIAL AND METHODS This study included living-donor KT recipients who underwent KT in our hospital from February 2002 to March 2023. The primary outcome was whether MRA decreased the prognosis of transplanted kidneys. The secondary outcomes were the risk factors for graft loss in KT with MRA, such as recipients' characteristic. RESULTS Out of 197 recipients, 47 (23.8%) received kidneys with MRA. In inverse probability of treatment weighting, the risk of graft loss did not increase in KT with MRA, as compared to that in KT with SRA (hazard ratio [HR]: 1.46; 95% confidence interval [CI]: 0.68-3.14). MRA were associated with graft loss in ABO blood-incompatible KT (HR: 5.09, 95% CI: 1.75-14.7). CONCLUSIONS In ABO blood-incompatible KT, MRA can increase risk of graft loss.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e946489"},"PeriodicalIF":1.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Transplant Success in COVID-19 Patients Requiring V-V ECMO: One-Year Follow-Up.","authors":"Mazen F Odish, Travis Pollema, Christine M Lin, Robert L Owens, Cassia Yi, Shannon LeBlanc, Chelsea Roche, Catherine Gaissert, Gordon Yung, Aarya Kafi, Eugene M Golts, Kamyar Afshar","doi":"10.12659/AOT.946088","DOIUrl":"10.12659/AOT.946088","url":null,"abstract":"<p><p>BACKGROUND Acute respiratory distress syndrome (ARDS) due to coronavirus 2019 (COVID-19) can result in severe disease requiring mechanical ventilatory support. A subset of these patients, however, demonstrate refractory hypoxemia/hypercarbia requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO) as adjunctive therapy. The primary goal of V-V ECMO is a \"bridge\" to recovery of native lung function; however, patients may progress to irreversible pulmonary damage requiring lung transplantation. MATERIAL AND METHODS We conducted a retrospective review of patients with refractory COVID-19 ARDS/pulmonary fibrosis that required a V-V ECMO bridge to lung transplantation at our institution from May 2021 to December 2022. Data for analysis included patient demographics, pre/post-transplantation course, and 1-year outcomes. RESULTS Nine patients (6 male, 3 female) with an average age of 44.6±12.1 years required V-V ECMO support for COVID-19 and subsequently underwent lung transplantation. The median number of ECMO days was 57 (IQR 53-78). At listing, these patients had a median lung allocation score (LAS) of 91.86 (IQR 89.05-92.13). The median hospital length-of-stay was 89 days (IQR 54-144) with the longest hospital stay at 255 days. All patients were discharged home and survived to 1-year post-transplant. CONCLUSIONS Our case series shows that patients with COVID-19 ARDS/pulmonary fibrosis had no meaningful difference in overall survival compared to our institution's overall 1-year lung transplant survival rate. Our results suggest that with careful selection and care, long-term lung transplantation outcomes can be equivalent for those requiring a bridge to transplantation with V-V ECMO support despite the severity of illness in the peri-transplant period.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e946088"},"PeriodicalIF":1.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Medical Accessibility on Long-Term Survival in Liver Transplantation.","authors":"Sung Jun Jo, Jinsoo Rhu, Jongman Kim, Gyu-Seong Choi, Jae-Won Joh","doi":"10.12659/AOT.944839","DOIUrl":"10.12659/AOT.944839","url":null,"abstract":"<p><p>BACKGROUND Medical accessibility is important in liver transplantation (LT) because of the risk of infections associated with the use of immunosuppressants and complications that require continuous treatment, such as biliary stenosis. However, the effect of medical accessibility on LT success rates has yet to be scrutinized. The aim of this retrospective observational study is to determine whether medical accessibility affects LT outcomes. MATERIAL AND METHODS We enrolled patients who had undergone LT at Samsung Medical Center between January 2017 and December 2021. The level of medical access was divided into 2 categories (difficult and easy) based on a cutoff of a 120-min commute on public transportation to access LT. Baseline characteristics were calibrated with propensity score matching. The outcomes (overall survival and graft survival) and severity of emergency center visits according to medical accessibility were also investigated. RESULTS A total of 486 patients was included in this study. The median time to reach the hospital by public transportation was 135 min. Sex, Child-Pugh classification, Model for End-stage Liver Disease score, presence of hepatocellular carcinoma, and donor type were calibrated with propensity score matching, and each group consisted of 186 patients. The overall survival (88.3% vs 86.2%, P=0.67, 5-year) and graft survival (98.6% vs 95.4%, P=0.086, 5-year) showed no significant differences between the difficult-to-access and easy-to-access groups. While severity of emergency center visits differed between the difficult group (27.6%) and the easy group (15.5%), the difference was not statistically significant. CONCLUSIONS Medical access to LT did tend to increase emergency center presentation severity but did not affect long-term outcomes.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944839"},"PeriodicalIF":1.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD146⁺ Endothelial Cells Facilitate Renal Interstitial Fibrosis Through Endothelial-to-Mesenchymal Transition.","authors":"Huixian Zhang, Liling Zhang, Dongli Tian, Yu Bai, Yiduo Feng, Wenhu Liu, Zongli Diao","doi":"10.12659/AOT.945917","DOIUrl":"10.12659/AOT.945917","url":null,"abstract":"<p><p>BACKGROUND Endothelial cells play a crucial role in the pathogenesis of renal interstitial fibrosis (RIF), with CD146 being upregulated on injured endothelial cells. However, the precise contribution of CD146⁺ endothelial cells to RIF remains unclear. This study aimed to observe and detect the relationship between CD146 expression and endothelial cells and to explore the role and possible mechanism of CD146 promoting endothelial-mesenchymal transition in RIF. MATERIAL AND METHODS In this study, we investigated the association between CD146⁺ endothelial cells and RIF. Double-label immunofluorescence was used in patients with chronic kidney disease, whereas multiplex immunofluorescence staining was used for the analysis in unilateral ureteral obstruction (UUO) mice. Hematoxylin and eosin and Masson trichrome staining were performed to evaluate RIF. RESULTS Our results revealed an elevation of CD146⁺ endothelial cells, which positively correlated with the degree of RIF in chronic kidney disease patients and UUO mice. Notably, CD146⁺ endothelial cells undergoing endothelial-mesenchymal transition (CD146⁺ EndMT) were significantly higher in subjects with severe renal interstitial fibrosis, as observed in chronic kidney disease patients and UUO mice. Additionally, with the progression of renal interstitial fibrosis, the expression of PDGFRb, the receptor of PDGF-B signaling pathway, increased and co-localized with CD146⁺ CD31⁺ a-SMA⁺ cells. The proportion of CD146⁺ CD31⁺ alpha-SMA⁺ PDGFRß⁺ cells in CD31⁺ cells increased. CONCLUSIONS In the process of renal interstitial fibrosis, CD146 is mainly expressed in renal interstitial vascular endothelial cells and participates in endothelial-to-mesenchymal transition, which may be related to the PDGF-B/PDGFR-ß signaling pathway.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945917"},"PeriodicalIF":1.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatopulmonary Syndrome and Liver Transplantation: Impact on Survival and Postoperative Complications.","authors":"Yin Lai, Hao-Chien Hung, Jin-Chiao Lee, Yu-Chao Wang, Chih-Hsien Cheng, Tsung-Han Wu, Ting-Jung Wu, Hong-Shiue Chou, Kun-Ming Chan, Wei-Chen Lee, Chen-Fang Lee","doi":"10.12659/AOT.945297","DOIUrl":"10.12659/AOT.945297","url":null,"abstract":"<p><p>BACKGROUND Liver transplantation (LT) is the preferred treatment for patients with cirrhosis who have hepatopulmonary syndrome (HPS). However, the effect of HPS on LT remains controversial. We assessed the correlation between HPS severity and LT survival and compared the incidence of postoperative complications between patients with and without HPS undergoing LT. MATERIAL AND METHODS We retrospectively reviewed the recipients who received living-donor LT in our institute between January 2016 and July 2019. Patients with HPS (HPS group) and patients without HPS (non-HPS group) were included in our study. HPS is defined as a defect in arterial oxygenation caused by the presence of intrapulmonary vascular dilatations, which is found by transthoracic echocardiography with pre-existing liver cirrhosis. HPS severity was graded according to the value of partial pressure of arterial oxygen. The demographic characteristics and clinical outcomes between the HPS and non-HPS groups were compared. RESULTS A total of 181 patients were enrolled. Among them, 104 patients (57.5%) had HPS. The mean overall survival of HPS and non-HPS groups was 69.82±3.1 vs 63.36±3.8 months, with no significant difference (P=0.332). The overall survival between different degrees of HPS was also compared, and showed no significant difference (P=0.466). The HPS group had a higher incidence of delayed extubation (22.1% vs 10.4%, P=0.028) and chest pigtail catheter insertion (16.3% vs 10.4%, P=0.012). Nevertheless, it did not lead to a longer Intensive Care Unit/hospital stay or higher risk of short-term mortality. CONCLUSIONS Patients with HPS tend to have more post-LT pulmonary complications, but the overall survival is not adversely influenced, regardless of the severity of HPS.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945297"},"PeriodicalIF":1.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Stress Disorders in Intensive Care Unit (ICU) Patients After Liver Transplantation: A Cross-Sectional Study.","authors":"Xiao-Qing Sun, Ying Xu, Xiu-Lian Wu, Jing-Jing Zhi, Yan-Mei Gu","doi":"10.12659/AOT.944320","DOIUrl":"10.12659/AOT.944320","url":null,"abstract":"<p><p>BACKGROUND Evidence on psychological factors associated with post-transplant post-traumatic stress disorder (PTSD) in liver transplantation (LT) patients is limited. Identifying the psychological factors associated with post-transplant PTSD would help to understand the symptoms of PTSD and take preventive measures. The aim of this study was to investigate factors influencing stress disorders in Intensive Care Unit (ICU) patients 1 year after LT. MATERIAL AND METHODS We assessed data from 184 LT patients at our hospital between January 2020 and December 2022. According to the PCL-C score, the patients were divided into the PTSD group (score ≤37) and the non-PTSD group (score >37). The demographic data, clinical data, the pain visual analogue scale (VAS), the anxiety and depression scale (HADS), and the psychological resilience scale (CD-RISC score) were compared between the 2 groups. Pearson correlation analysis was used to analyze the correlation between PCL-C and VAS, HADS, and CD-RISC, and logistic regression was used to analyze the factors influencing PTSD. SPSS 23.0 software was used for statistical analysis. RESULTS The average age of the 184 participants was 53.17 years (±3.47) and 66.85% of the subjects were male. The prevalence rate of post-transplant PTSD was 22.83% and the total score on the PCL-C scale was 32.47±7.81. Pearson correlation analysis showed that PCL-C score was positively correlated with VAS (r=0.312, P=0.012) and HADS (r=0.412, P<0.001), and negatively correlated with CD-RISC (r=-0.468, P<0.001). Logistic regression analysis showed that the symptom of post-transplant PTSD was significantly associated with higher VAS (OR=1.058, P=0.007) and HADS (OR=1.885, P<0.001) scores and lower CD-RISC (OR=2.213, P<0.001) score, which indicated that higher VAS and HAD scores were risk factors that contributed to PTSD and lower CD-RISC was a protective factor against PTSD. CONCLUSIONS We found that pain, anxiety, depression, and resilience were associated with symptoms of PTSD in LT patients in the ICU. Nursing staff should seek to relieve their patients' pain and assure provision of targeted health education and personalized psychological counseling to reduce the risk of PTSD after LT.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944320"},"PeriodicalIF":1.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}