Optimal time of liver transplantation for chronic severe hepatitis(analysis of 59 cases)

Objective To explore the optimal time of liver transplantation for chronic severe hepatitis.Methods The clinical data of 59 cases of chronic severe hepatitis admitted from September 2003 to July 2005 were analysed.Among these 59 patients,52 underwent liver transplantation(group 1),and the other 7 did not(group 2).The timing and prognosis of liver transplantation were studied.Results One-year survival rate in group 1 and group 2 was 83.3% and 14.3%,respectively(P0.01).If the patients in group 1 were further divided into two subgroups according to the score of model for end-stage liver disease(MELD) the mean operation time,one-year survival rate,blood loss during the operation,quantity of blood transfusion,respiratory support time after the operation,intensive care unit hospitalization time,total hospitalization duration,mean cost,infective morbidity,as well as the incidence of renal failure were(7.3±2.6) h,76.5%,(4 860±1980) ml,(5 240±2160) ml,(5.3±2.2) d,(6.1±2.7) d,(31.7±11.6) d,(369±93) thousand RMB,71.4%,and 23.8% in patients with MELD score≥16,while they were(5.4±1.5) hours,89.5%,(1780±670) ml,(2110±790) ml,(3.2±2.1) d,(3.4±2.0) d,(23.8±7.5) d,(232±52) thousand RMB,35.4% and 3.2% respectively in patients with MELD score16.Conclusions The chronic severe hepatitis patients with a MELD score higher than 12 or lower than 16 are suitable candidates for liver transplantation.The prognosis would be poor if the MELD score exceeds 16.