| Purpose: To explore the significant prognostic markers of severe hepatitis and suggest the indication for liver transplantation Method: The study was based on summarized medical records of Southwest Hospital collected from 1990 to 2001. Binary Logistic regression analysis was carried out with SPSS 10.0 statistical software package. Four significant prognostic markers were selected from many clinical parameters. Then, according to our experience of liver transplantation , we suggest the indication for liver transplantation for patients with severe hepatitis. Result:1, 593 patients (61.1%)died in total 971 patients with severe hepatitis. 2, Independent prognostic markers : age≥38 years ;serum bilirubin ≥416umol/L; prolongation of prothrombin time by ≥17.3seconds over control; simultaneous encephalopathy .3, Respective mortality was 56.7% ,86.0%,95.1%,100% when any one factor ,two factors ,three and four factors exist.4, Liver transplantation was performed for 14 patients with severe hepatitis in Southwest Hepatobiliary Hospital during past three years. The mortality of the operation was zero. 10 patients was survival and obtained high quality of life. The other 4 patients with preoperative serious complications died from postoperative multiple organ function failure . Conclusion: According to the analysis of clinical parameters of patients with severe1． hepatitis ,we can early predict their prognosis.2． Among the clinical parameters, independent prognostic markers are: age≥38 years ;serum bilirubin ≥416umol/L; prolongation of prothrombin time by ≥17.3seconds over control; simultaneous encephalopathy .3． The patiens with severe hepatitis can achieve good short- and long-term outcome by timely liver transplantation .The timing of operation is very important for the successful liver transplantation.4． We conclude the indication for liver transplantation for patients with severe hepatitis are : age≥38 years ;serum bilirubin > 400umol/L; prolongation of prothrombin time by > 17seconds over control; simultaneous encephalopathy. |
