Can Patients Who Develop Cerebral Death in Fulminant Liver Failure Despite Liver Transplantation Be Previously Forseen?

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dc.authoridince, volkan/0000-0002-0714-490X
dc.authoridSARICI, KEMAL BARIŞ/0000-0001-9595-1906
dc.authoridYilmaz, Sezai/0000-0002-8044-0297
dc.authoridKARAKAS, SERDAR/0000-0001-8314-7806
dc.authoridKoc, Cemalettin/0000-0002-5676-6772
dc.authorwosidKayaalp, Cuneyt/AAH-1764-2021
dc.authorwosidince, volkan/M-7325-2017
dc.authorwosidSARICI, KEMAL BARIŞ/ABI-4356-2020
dc.authorwosidYilmaz, Sezai/ABI-2323-2020
dc.authorwosidKARAKAS, SERDAR/AAB-3219-2021
dc.authorwosidKoc, Cemalettin/B-6430-2018
dc.contributor.authorSarici, K. B.
dc.contributor.authorKarakas, S.
dc.contributor.authorOtan, E.
dc.contributor.authorInce, V.
dc.contributor.authorKoc, C.
dc.contributor.authorKoc, S.
dc.contributor.authorBayraktar, H.
dc.date.accessioned2024-08-04T20:43:02Z
dc.date.available2024-08-04T20:43:02Z
dc.date.issued2017
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground. The outcome of medical treatment is worse in fulminant liver failure (FLF) developing on acute or chronic ground. Recently, liver transplantations with the use of living and cadaveric donors have been performed in these diseases and good results obtained. In this study, we aimed to present the factors affecting the recovery of cerebral functions after liver transplantation in hepatic encephalopathy (HE) developing in FLF, to identify irreversible patient groups and to prevent unnecessary liver transplantation. Methods. In Inonu University's Liver Transplant Institute, 69 patients who made an emergency notice to the National Coordination Center for liver transplantation owing to FLF from January 2012 to December 2015 were included in the study. Patients were divided into 2 groups. Group 1 consisted of 52 patients who underwent liver transplantation and recovered normal brain function, and group 2 had 17 patients who underwent liver transplantation and did not recover normal brain function and had cerebral death. All patients were evaluated before surgery for clinical encephalopathy stage, light reflex, and convulsions. Groups were compared and assessed according to age (>40, 10-40 and <10 years), body mass index, etiologic factor, preoperative laboratory values, transplantation type, mortality, and encephalopathy level. Multivariate analysis was done for specific parameters. Results. Prothrombin time (PT), international normalized ratio (INR), and total bilirubin values were significantly different between the groups. There was no significant difference between the groups regarding ammonia and lactate levels. There was a statistically significant difference between the groups regarding sodium and potassium levels from serum electrolytes. However, the averages of both groups were within normal limits. pH and total bilirubin levels were meaningful for multivariate analysis. Conclusions. HE reversibility, mortality, and morbidity are important in patients with HE who undergo liver transplantation. Therefore, West Haven clinical staging and serum INR, PT, and total bilirubin level may be helpful in predicting the reversibility of FLF patients with HE before liver transplantation. It was determined that West Haven encephalopathy grading is important in determining the reversibility of HE after transplantation in FLF; especially the probability of reversibility of stage 4 HE decreases significantly. High PT and INR levels, hyperbilirubinemia, and serum sodium and potassium concentrations were risk factors for the reversibility of HE in this study.en_US
dc.identifier.doi10.1016/j.transproceed.2017.01.036
dc.identifier.endpage574en_US
dc.identifier.issn0041-1345
dc.identifier.issn1873-2623
dc.identifier.issue3en_US
dc.identifier.pmid28340835en_US
dc.identifier.scopus2-s2.0-85015853799en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage571en_US
dc.identifier.urihttps://doi.org/10.1016/j.transproceed.2017.01.036
dc.identifier.urihttps://hdl.handle.net/11616/97743
dc.identifier.volume49en_US
dc.identifier.wosWOS:000398017900039en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofTransplantation Proceedingsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectSerum Sodium Concentrationen_US
dc.subjectArterial Ammoniaen_US
dc.subjectMortalityen_US
dc.titleCan Patients Who Develop Cerebral Death in Fulminant Liver Failure Despite Liver Transplantation Be Previously Forseen?en_US
dc.typeArticleen_US

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