Aplicação do escore MELD em pacientes submetidos a transplante de fígado: análise retrospectiva da sobrevida e dos fatores preditivos a curto e longo prazo

Boin, Ilka de Fátima Santana Ferreira; Leonardi, M.I.; Udo, E.Y.; Sevá‐Pereira, Tiago; Stucchi, Raquel Silveira Bello; Leonardi, Luiz Sérgio

doi:10.1590/s0004-28032008000400004

Cited by 23 publications

(17 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Normally, AUC values e" 0.7 are considered clinically useful, whereas values d" 0.5 are related to scores with no discriminatory power 3,16,17 . Based on the results found, the preoperative MELD score showed low overall accuracy for predicting survival after HT, similar to that described in other Brazilian studies 3,18 . Also, since the survival of transplanted patients with HCC is influenced by parameters related to the tumor 19 , we performed analyzes stratified between subgroups HCC and non-HCC.…”

Section: Methods Methods Methods Methodssupporting

confidence: 87%

“…This low proportion of patients with high scores likely contributed to minimize its overall accuracy for predicting survival after TH in this series. Intraoperative transfusion of red blood cells has often been related to lower survival after liver transplants 18,[25][26][27][28] , which can also be seen in this series, which identified a strong influence of the transfusion of blood components in the medium-term survival of transplant patients. This negative effect of blood transfusions probably stems from immunomodulation related to transfusions and changes of its components from storage process 29 , which may increase the risk of nosocomial infections, acute lung injury and development of autoimmune diseases in the long term 30 .…”

Section: Methods Methods Methods Methodssupporting

confidence: 66%

See 1 more Smart Citation

Emprego do escore MELD para a predição da sobrevivência pós-transplante hepático

Batista¹,

Sabat²,

Melo³

et al. 2012

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

. We used analysis of area under ROC (receiver operating characteristic) as a summary measure of the performance of the MELD score and assessed predictors of medium-term survival using univariate and multivariate analysis. Results Results ResultsResults Results: The cumulative survival of three, six, 12 and 24 months of the 208 patients studied was 85.1%, 79.3%, 74.5% and 71.1%, respectively. The preoperative MELD score showed a low discriminatory power for predicting survival after TH. By univariate analysis, we identified intraoperative transfusion of red blood cells (p <0.001) and platelets (p = 0.004) and type of venous hepatocaval anastomosis (p = 0.008) as significantly related to medium-term survival of the patients studied. However, by multivariate analysis only red blood cell transfusion was a significant independent predictor of outcome. Conclusion Conclusion Conclusion Conclusion Conclusion: The MELD score showed low overall accuracy for predicting post-transplant survival of patients studied, among which only intraoperative transfusion of red blood cells was identified as an independent predictor of survival in the medium term after TH.

show abstract

Section: Methods Methods Methods Methodssupporting

confidence: 87%

Section: Methods Methods Methods Methodssupporting

confidence: 66%

Emprego do escore MELD para a predição da sobrevivência pós-transplante hepático

Batista¹,

Sabat²,

Melo³

et al. 2012

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

show abstract

“…Most of the studies (21,22,24,25,27,28,30,32) assessed the relationship between exercise capacity and the Child-Pugh scoring -this model was created to predict life mortality and expectancy in patients with hepatic cirrhosis (38,39). Even though some studies did not find a negative correlation between exercise capacity and Child-Pugh scoring (21,22,34,35), it has been suggested that hepatic cirrhosis can affect cardiorespiratory capacity during exercise (24,25,27,28,30,32).…”

Section: Methodsmentioning

confidence: 99%

The influence that hepatic cirrhosis provides in exercise capacity and muscle strength: a review

2015

View full text Add to dashboard Cite

Introduction: Hepatic cirrhosis leads to a series of physiological changes, among which stand out cardiorespiratory and muscle impairments. These changes determine a negative impact on quality of life and may cause physical inactivity. Objective: The objective of this study was to review, in the most current scientific literature, the influence that hepatic cirrhosis provides in exercise capacity and muscle strength, and the effect of exercise when applied to this situation. Materials and methods: For this review, research on original studies was carried out on Medical Literature Analysis and Retrieval System Online (assessed by PubMed), Scopus and Web of Science between the years 1990 to 2015. In order to be included, studies had to meet the following criteria: a) be from original articles; b) evaluate exercise capacity or muscle strength; and c) provide relevant results. Results and Discussion: The majority of studies concluded that the exercise capacity and muscle strength are decreased in individuals with cirrhosis when compared to control subjects.

show abstract

“…1 A study published in the United States in 2014 indicates that as of July 26 2013, there were 118,895 Americans waiting for organ transplants, among which 15,773 were waiting for liver transplants. 2 World-wide experiments confirm the success of liver transplantation as a definitive cure for hepatocellular carcinoma, the seventh most common type of cancer worldwide since it allows the total removal of the tumor, [3][4] and is also indicated for patients with decompensated cirrhosis and acute liver failure.…”

Section: Introductionmentioning

confidence: 99%

“…9 Liver transplants have been performed in Brazil since 1968. 1 As a result of the technological advances and improvements in surgical techniques, it was possible to optimize the time of surgery and recovery of patients undergoing liver transplantation. Twenty years ago, the surgery lasted between 17 and 24 hours and currently on average, it takes five hours.…”

Section: Introductionmentioning

confidence: 99%

Specialist Service in Liver Transplant in a University Hospital: A Case Study

Ferrazzo

Vargas

Gomes

et al. 2017

Texto contexto - enferm.

View full text Add to dashboard Cite

Objective: was to describe the flow of a specialist service in the care of liver transplant in a university hospital.Method: a qualitative research in the form of a case study, performed in a transplant service in southern Brazil. Data collection occurred from November 2013 to February 2014 through the triangulation of data, document analysis, structured interviews with 11 professional and semi direct observations interviews. Data analysis was performed by analysis of thematic content.Results: describes the flow of service and revealed the involvement of a multidisciplinary team in a cohesive manner, with competence recognized by patients and other sectors of the institution and structural deficiencies in care service for immunosuppressed patients. Conclusion: it was found that there is a need for studies that address the structures of care in liver transplantation services and to evaluate the impact of the quality of the life expectancy and proper recovery of persons undergoing liver transplantation. SERVIÇO ESPECIALIZADO EM TRANSPLANTE HEPÁTICO EM UM HOSPITAL UNIVERSITÁRIO: UM ESTUDO DE CASO RESUMOObjetivo: descrever o fluxo do serviço especializado no atendimento em transplante hepático de um hospital universitário.Método: pesquisa qualitativa, do tipo estudo de caso, realizada em um serviço de transplante do sul do Brasil. A coleta dos dados ocorreu no período de novembro de 2013 a fevereiro de 2014 por meio da triangulação dos dados, análise documental, entrevistas semiestruturadas com 11 profissionais e observações diretas. A análise de dados foi realizada pela análise de conteúdo temática.Resultados: os achados descreveram o fluxo do serviço e revelaram a atuação de uma equipe multidisciplinar de forma coesa, com competência reconhecida por pacientes e demais setores da instituição, carências estruturais no serviço para atendimento de pacientes imunossuprimidos.Conclusão: constatou-se que há necessidade de estudos que abordem as estruturas dos atendimentos em serviços de transplante de fígado e avaliem o impacto da qualidade dessas na expectativa de vida e na adequada recuperação das pessoas submetidas ao transplante hepático. Método: la investigación cualitativa, estudio de caso, realizado en un servicio de trasplante en un hospital universitario en el sur de Brasil. La recolección de datos se produjo de la Investigación, a partir de noviembre 2013 a febrero 2014 a través de la triangulación de datos, análisis de documentos, entrevistas estructuradas con 11 profesionales y semi observaciones entrevistas directas. El análisis de datos se realizó mediante el análisis de contenido temático. DESCRITORES:Resultados: describir el flujo de servicio y revelaron la participación de un equipo multidisciplinario de manera coherente, con reconocida competencia por los pacientes y otros sectores de la institución y las deficiencias estructurales en el servicio de atención a los pacientes inmunodeprimidos.Conclusión: se encontró que hay una necesidad de estudios que se ocupan de las estructuras de atención en...

show abstract

Aplicação do escore MELD em pacientes submetidos a transplante de fígado: análise retrospectiva da sobrevida e dos fatores preditivos a curto e longo prazo

Cited by 23 publications

References 41 publications

Emprego do escore MELD para a predição da sobrevivência pós-transplante hepático

Emprego do escore MELD para a predição da sobrevivência pós-transplante hepático

The influence that hepatic cirrhosis provides in exercise capacity and muscle strength: a review

Specialist Service in Liver Transplant in a University Hospital: A Case Study

Contact Info

Product

Resources

About