わが国における劇症肝炎の予後予測と肝移植の適応に関する多施設研究　　日本急性肝不全研究会１９９６年肝移植適応ガイドライン策定の経緯

DOI Web Site 被引用文献24件 参考文献28件

書誌事項

タイトル別名
  • A Multicenter Study on the Prognosis and Indications of Liver Transplantation for Fulminant Hepatitis in Japan. Details of Decision of the Guideline for Liver Transplantation in Japanese Acute Hepatic Failure Study Group (1996).
  • Details of Decision of the Guideline for Liver Transplantation in Japanese Acute Hepatic Failure Study Group (1996)
  • 日本急性肝不全研究会1996年肝移植適応ガイドライン策定の経緯

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説明

We prepared a guideline for indication of liver transplantation for fulminant hepatitis (FH) retrospectively by multivariate analysis of multicenter data and, then, conducted a prospective evaluation of the guideline by questionnaire survey. In the guideline, patients were registered as candidates of liver transplantation and recommended transplant if possible, when 2 or more of the following 5 criteria were fulfilled at the onset of hepatic encephalopathy (HE): 1) age of 45 years or above, 2) interval from appearance of initial symptoms to the onset of HE of 11 days or longer, 3) prothrombin time (PT) of less than 10%, 4) serum total bilirubin concentration of 18.0mg/dl or above, 5) direct/total bilirubin ratio of 0.67 or less. If liver transplantation was unable within 5 days, the patients were re-predicted to survive 1) when coma grade of HE was improved to grade 1 or less or by 2 or more grades and 2) when PT improved above 50% during this period; they were otherwise re-predicted to die and kept registered. When this guideline was tested prospectively, predictive accuracy was 0.82. This guideline is useful for evaluation of indications of liver transplantation for FH in Japan.

収録刊行物

  • 肝臓

    肝臓 42 (10), 543-557, 2001

    一般社団法人　日本肝臓学会

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