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소아 간이식 후 신경학적 합병증; 위험 인자 및 생존률과의 관계 : Risk factors for neurological complications and their correlation with survival following pediatric liver transplantation 원문보기

  • 저자

    이윤정

  • 학위수여기관

    울산대학교

  • 학위구분

    국내석사

  • 학과

    의학과 소아청소년과

  • 지도교수

    고태성

  • 발행년도

    2014

  • 총페이지

    33 p.

  • 키워드

    liver transplantation neurological complication immunosuppressive treatment children;

  • 언어

    eng

  • 원문 URL

    http://www.riss.kr/link?id=T13540371&outLink=K  

  • 초록

    Purpose: Despite the improved outcomes of liver ransplantation (LT), post-operative neurologic complications (NCs) remain a significant cause of morbidity and mortality. The aim of the study was to identify the incidence of and risk factors for NCs in children who underwent LT. Methods: The medical records of pediatric patients who underwent LT at Asan Medical Center Children's Hospital between January 1994 and December 2010 were retrospectively analyzed. The onset and types of NC and pretransplant variables associated with NC were evaluated. Results: A total of 190 children (85 boys [44.7%], 105 girls [55.3%]) were reviewed. The mean age was 4.1 ± 4.7 years. The most frequent primary liver disease requiring LT was biliary atresia (BA) (n = 105 [55.3%]), followed by ALF (n = 32 [16.8%]), and Wilson disease (n = 15 [7.9%]). Forty-six NCs occurred in 41 (21.6%) patients after LT. The most common was seizure (n = 13, 28.3%), followed by encephalopathy (n = 10, 21.7%), other psychiatric symptoms (n = 9, 19.6%), and headache (n = 5, 10.9%). Of these 41 patients with NC, 14 (34.1%) had neurologic problems prior to LT, compared with 28 of the 149 children (18.8%) without posttransplant NC (p = 0.036). Of the 46 NCs, 24 (52.2%) occurred within three months after LT. Multivariate analysis showed that primary liver disease, preoperative neurological problems, preoperatively higher serum creatinine concentration, and graft failure were significant risk factors for NCs. The survival rate was significantly lower for patients with NCs than for those without (p


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