RESUMEN
INTRODUCTION: Primary graft dysfunction (PGD) is a multifactorial syndrome related to the most adverse outcomes after liver transplantation. Ischemia-reperfusion injury is recognized as the predominant cause of this complication. PGD may be subdivided into early allograft dysfunction, diagnosed by the presence of a serum bilirubin level ≥10 mg/dL (171 µmol/L), International Normalized Ratio ≥1.6, or alanine and aspartate transaminase levels ≥2000 IU/L on the seventh postoperative day; and primary nonfunction, defined as either a need for retransplantation or patient death within the first 7 days. We aimed to determine the preoperative and intraoperative risk factors for PGD. MATERIALS AND METHODS: We enrolled 109 patients who underwent orthotopic liver transplantation between 2012 and 2016. Analysis included inter alia: biochemical parameters, morphology, blood transfusions, as well as intraoperative fluctuations of blood pressure. RESULTS: Fourteen percent of patients were diagnosed with PGD. Using logistic regression and multivariate and receiver operating characteristic and area under the curve analysis, a preoperative neutrophils level above 4030/µL (OR = 4.03, P = .012) and decrease of the mean arterial pressure after reperfusion were recognized as the major independent PGD risk factors. CONCLUSIONS: A high preoperative neutrophils level may be a novel recipient-related risk factor for PGD. A decrease of the arterial blood pressure after graft reperfusion may influence the development of PGD.
Asunto(s)
Complicaciones Intraoperatorias/etiología , Trasplante de Hígado/efectos adversos , Disfunción Primaria del Injerto/etiología , Reoperación/estadística & datos numéricos , Adulto , Femenino , Humanos , Trasplante de Hígado/métodos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Periodo Preoperatorio , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , Resultado del TratamientoRESUMEN
Stomatological and mycological examinations of the workers at the fusion department of the RZWM "Silesia" showed a considerable intensification of paradontium diseases (about 80% of cases). Leukoplakia and candidiasis were the most common changes found on the mucous membrane in the oral cavity. Mycological investigations carried out on the Sabourand culture showed Candida albicans in 73,7% of cases.