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- Enhanced recovery after liver transplantation-a prospective analysis focusing on quality assessment 认领 引用 被引量：4
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- 作者 Xiaodong Yuan Jiwei Qin +25 位作者 Hao Zheng Can Qi Yafei Guo Zebin Zhu Wei Wu Zhijun Xu Xuefeng Li Ning Wang Xiaoqing Chai Yanhu Xie Xiaogen Tao Haihua Liu Weiyong Liu Guoyan Liu Lei Ye Kexue Deng Yi Li Xuebing Ji Changlong Hou Zhiqin Yao Qiang Huang Ruipeng Song Shugeng Zhang Jizhou Wang Lianxin Liu Björn Nashan 《Hepatobiliary Surgery and Nutrition》 SCIE 2025年第3期423-441,共19页
- Background:Enhanced Recovery After Surgery(ERAS)is a multimodal approach for almost all types of surgical procedures,including liver transplantation(LTx).We developed an ERAS protocol for LTx based on previous experie... Background:Enhanced Recovery After Surgery(ERAS)is a multimodal approach for almost all types of surgical procedures,including liver transplantation(LTx).We developed an ERAS protocol for LTx based on previous experience and assessed it using benchmarks from the German Institute for Quality Management and Transparency in Healthcare(IQTIG).Methods:An ERAS protocol was developed and implemented in our center since 2018 for LTx,including preoperative,intraoperative,and postoperative procedures.From January 2021 to December 31st 2022,we conducted a prospective analysis including donor and recipient demographics,Model for End-Stage Liver Disease(MELD)score and medical history.Perioperative management,such as operative time,anhepatic phase time,intensive care unit(ICU)stay,morbidity and mortality as well as postoperative hospitalization,readmission and 1-year patient survival,were collected as outcome measures.Results:Sixty-eight consecutive liver transplant recipients were included.Mean age of the donors was 47(36-55.5)years old,type of donation was in 41 donation after brain death(DBD),26 donation after controlled circulatory death(DCD)and 1 donation after brain and cardiac death(DBCD).Mean age of the patients was 49.6 years(range,26-68 years),81%were male.The mean body mass index(BMI)of the recipients was 24 kg/m2(range,15-37 kg/m2),mean MELD score was 15(range,6-39),3 patients had a MELD score higher than 30.Fifty-three patients suffered from hepatitis B virus(HBV)related cirrhosis.Twenty-eight patients had hepatocellular carcinoma(HCC);5 patients were diagnosed with alcohol related cirrhosis and primary biliary cirrhosis,autoimmune disease and drug induced cirrhosis,undefined cirrhosis,respectively.The mean operation time in our cohort was 6.73 hours,and the average anhepatic phase time was 68 minutes.No patient had intraoperative hypothermia.Tracheal extubation was performed in the ICU department within 6 hours post operation and the average ICU/intermediate care(IMC)unit stay was 4.5 days(range,2-14 days).None of the patients required re-intubation.Postoperative complications with a CDC classification>II were seen in 16 patients(23.5%).Mean hospital stay was 21.7 days and readmission rate was 13(19%).Neither acute rejection nor postoperative mortality during the hospital stay was recorded.One patient died from acute myocardial infarction after discharge.Conclusions:We developed an ERAS protocol in LTx,consisting of preoperative,perioperative and postoperative management and assessed the quality using benchmarks from IQTIG.Our study revealed that the proposed ERAS approach in LTx is feasible offering the opportunities of enhanced recovery and quality management. 展开更多
- 关键词 Enhanced Recovery After Surgery(ERAS) liver transplantation(LTx) quality management IQTIG benchmarks
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- One-year status of hepatic venous pressure gradient measurement from 85 hospitals in China 认领 引用
- 2
- 作者 Jitao Wang Ting Cui +87 位作者 Linpeng Zhang Zhiping Yan Lei Li Jinjun Chen Junhui Sun Hua Xiang He Zhu Hao Wu Jiancuo Gengzang Feng Zhang Wei Wu Guohong Cao Wuhua Guo Haibin Shi Hui Xue Guangjun Huang Qiang Yu Meng Niu Huiling Xiang Derun Kong Wei Gou Xuefeng Luo Fuliang He Min Yuan Wei Liu Yong Wang Hongjie Hu Xiaoli Zhu Tao Yu Qinxue Sun Wei Qu Ting Lu Deqiang Ma Li Zhang Jun Ma Jun Yang Ketao Mu Xiaoliang Zhu Kai Xiong Huiguo Ding Shengjuan Yao Mingsheng Huang Fang Wang Zexin Wang Yong Huang Jianan Li Hongfeng Yi Birun Huang Zhongwei Zhao Duiping Feng Yanming Lei Changlong Hou Wenbo Guo Shirong Liu Gaojun Teng Kangshun Zhu Fan Wu Xiaogang Hu Wenfeng Zhang Shaoqi Yang Zhouchao Hu Pengfei Pang Shaowu Zhuang Weidong Wang Qingliang Zhu Kunpeng Zhang Chengyu Liu Dongliang Li Chao Ma Hong Jiang Xingong Zhao Weixin Ren Zhiwei Wang Lei Yu Fuhuang Lin Chaoguang Yan Feng Wang Lei Yu Hui Huan Wenyong Shen Shaofei He Chengda Zhang Jinlun Bao Jiangtao Liu Jun Wu Jianbo Zhao Jian Zhang Xiaolong Qi 《Portal Hypertension & Cirrhosis》 2024年第2期116-123,共8页
- Aims:Surveys and research on the applications of the hepatic venous pressure gradient(HVPG)are important for understanding the current status and future development of this technology in China.This article aimed to in... Aims:Surveys and research on the applications of the hepatic venous pressure gradient(HVPG)are important for understanding the current status and future development of this technology in China.This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022.Methods:We investigated the overall status of HVPG technology in China-including hospital distribution,hospital level,annual number of cases,catheters used,average cost,indications,and current challenges by using online questionnaire.By counting the number and percentages of cases of these results,we hope to clarify the current status of HVPG measurements in China.Results:According to the survey,85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces.A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022,of which 2813 cases(56.4%)were measured alone.The average cost of HVPG measurement was 5646.8±2327.9 CNY.Of the clinical teams who performed the measurements(sometimes multiple per hospital),94.3%(82/87)used the balloon method,and the majority of the teams(72.4%,63/87)used embolectomy catheters.Conclusions:This survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology.It is still necessary to continue promoting and popularizing this technology in the future. 展开更多
- 关键词 application status hepatic vein pressure gradient questionnaire survey
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- 题名Enhanced recovery after liver transplantation-a prospective analysis focusing on quality assessment 认领 引用 被引量：4
- 1
- 作者 Xiaodong Yuan Jiwei Qin Hao Zheng Can Qi Yafei Guo Zebin Zhu Wei Wu Zhijun Xu Xuefeng Li Ning Wang Xiaoqing Chai Yanhu Xie Xiaogen Tao Haihua Liu Weiyong Liu Guoyan Liu Lei Ye Kexue Deng Yi Li Xuebing Ji Changlong Hou Zhiqin Yao Qiang Huang Ruipeng Song Shugeng Zhang Jizhou Wang Lianxin Liu Björn Nashan
- 机构 The Transplantation Center,The First Affiliated Hospital of the USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Anesthesia,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Intensive Care Unit,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Ultrasound Medicine,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Radiology,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Infectious Disease,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Intervention,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Organ Procurement Organization,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of General Surgery,Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China Department of Hepatobiliary Surgery,Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China
- 出处 《Hepatobiliary Surgery and Nutrition》 SCIE 2025年第3期423-441,共19页
- 基金 supported by the Anhui Provincial Natural Science Foundation(No.2108085MH256 to X.Y.) the Fundamental Research Funds for the Central Universities(No.WK9110000055 to B.N.,No.WK9110000131 to X.Y.).
- 摘要 Background:Enhanced Recovery After Surgery(ERAS)is a multimodal approach for almost all types of surgical procedures,including liver transplantation(LTx).We developed an ERAS protocol for LTx based on previous experience and assessed it using benchmarks from the German Institute for Quality Management and Transparency in Healthcare(IQTIG).Methods:An ERAS protocol was developed and implemented in our center since 2018 for LTx,including preoperative,intraoperative,and postoperative procedures.From January 2021 to December 31st 2022,we conducted a prospective analysis including donor and recipient demographics,Model for End-Stage Liver Disease(MELD)score and medical history.Perioperative management,such as operative time,anhepatic phase time,intensive care unit(ICU)stay,morbidity and mortality as well as postoperative hospitalization,readmission and 1-year patient survival,were collected as outcome measures.Results:Sixty-eight consecutive liver transplant recipients were included.Mean age of the donors was 47(36-55.5)years old,type of donation was in 41 donation after brain death(DBD),26 donation after controlled circulatory death(DCD)and 1 donation after brain and cardiac death(DBCD).Mean age of the patients was 49.6 years(range,26-68 years),81%were male.The mean body mass index(BMI)of the recipients was 24 kg/m2(range,15-37 kg/m2),mean MELD score was 15(range,6-39),3 patients had a MELD score higher than 30.Fifty-three patients suffered from hepatitis B virus(HBV)related cirrhosis.Twenty-eight patients had hepatocellular carcinoma(HCC);5 patients were diagnosed with alcohol related cirrhosis and primary biliary cirrhosis,autoimmune disease and drug induced cirrhosis,undefined cirrhosis,respectively.The mean operation time in our cohort was 6.73 hours,and the average anhepatic phase time was 68 minutes.No patient had intraoperative hypothermia.Tracheal extubation was performed in the ICU department within 6 hours post operation and the average ICU/intermediate care(IMC)unit stay was 4.5 days(range,2-14 days).None of the patients required re-intubation.Postoperative complications with a CDC classification>II were seen in 16 patients(23.5%).Mean hospital stay was 21.7 days and readmission rate was 13(19%).Neither acute rejection nor postoperative mortality during the hospital stay was recorded.One patient died from acute myocardial infarction after discharge.Conclusions:We developed an ERAS protocol in LTx,consisting of preoperative,perioperative and postoperative management and assessed the quality using benchmarks from IQTIG.Our study revealed that the proposed ERAS approach in LTx is feasible offering the opportunities of enhanced recovery and quality management.
- 关键词 Enhanced Recovery After Surgery(ERAS) liver transplantation(LTx) quality management IQTIG benchmarks
- 分类号 R657.3 [医药卫生—外科学]
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- 题名One-year status of hepatic venous pressure gradient measurement from 85 hospitals in China 认领 引用
- 2
- 作者 Jitao Wang Ting Cui Linpeng Zhang Zhiping Yan Lei Li Jinjun Chen Junhui Sun Hua Xiang He Zhu Hao Wu Jiancuo Gengzang Feng Zhang Wei Wu Guohong Cao Wuhua Guo Haibin Shi Hui Xue Guangjun Huang Qiang Yu Meng Niu Huiling Xiang Derun Kong Wei Gou Xuefeng Luo Fuliang He Min Yuan Wei Liu Yong Wang Hongjie Hu Xiaoli Zhu Tao Yu Qinxue Sun Wei Qu Ting Lu Deqiang Ma Li Zhang Jun Ma Jun Yang Ketao Mu Xiaoliang Zhu Kai Xiong Huiguo Ding Shengjuan Yao Mingsheng Huang Fang Wang Zexin Wang Yong Huang Jianan Li Hongfeng Yi Birun Huang Zhongwei Zhao Duiping Feng Yanming Lei Changlong Hou Wenbo Guo Shirong Liu Gaojun Teng Kangshun Zhu Fan Wu Xiaogang Hu Wenfeng Zhang Shaoqi Yang Zhouchao Hu Pengfei Pang Shaowu Zhuang Weidong Wang Qingliang Zhu Kunpeng Zhang Chengyu Liu Dongliang Li Chao Ma Hong Jiang Xingong Zhao Weixin Ren Zhiwei Wang Lei Yu Fuhuang Lin Chaoguang Yan Feng Wang Lei Yu Hui Huan Wenyong Shen Shaofei He Chengda Zhang Jinlun Bao Jiangtao Liu Jun Wu Jianbo Zhao Jian Zhang Xiaolong Qi
- 机构 Hebei Provincial Key Laboratory of Cirrhosis&Portal Hypertension,Xingtai People's Hospital,Xingtai Center of Portal Hypertension,Department of Radiology,Zhongda Hospital,School of Medicine,Southeast University Department of Interventional Therapy,Beijing Shijitan Hospital Affiliated to Capital Medical University Department of Intervention,Taiyuan Third People's Hospital,Taiyuan Department of Intervention,Zhongshan Hospital Affiliated to Fudan University Department of Interventional Medicine,The First Hospital of Lanzhou University,Lanzhou Department of Infectious Diseases,Nanfang Hospital of Southern Medical University Hepatobiliary and Pancreatic Intervention Center,The First Affiliated Hospital of Zhejiang University School of Medicine Interventional Vascular Surgery,Hunan Provincial People's Hospital Department of Intervention,Sixth People's Hospital of Shenyang,Shenyang Department of Gastroenterology,West China Hospital of Sichuan University Department of Intervention,The Fourth People's Hospital of Qinghai Province Department of Gastroenterology,Nanjing Drum Tower Hospital Department of Gastroenterology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou Department of Radiology,Shulan（Hangzhou）Hospital Department of Intervention,Mengchao Hepatobiliary Hospital of Fujian Medical University Department of Interventional Radiology,The First Affiliated Hospital of Nanjing Medical University Department of Gastroenterology,The First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Department of Gastroenterology,Shandong Provincial Hospital Affiliated to Shandong First Medical University Department of Interventional Radiology,Fifth Medical Center of General Hospital of Chinese People's Liberation Army Department of Interventional Therapy,The First Affiliated Hospital of China Medical University,Shenyang Department of Gastroenterology,Tianjin Third Central Hospital Department of Gastroenterology,The First Affiliated Hospital of Anhui Medical University Department of Metabolic Hepatology,Qingdao Sixth People's Hospital,Qingdao Liver Disease Center,Beijing Friendship Hospital,Capital Medical University Department of Intervention,Shanghai Public Health Clinical Center Department of Intervention,People's Hospital of Lishui,Zhejiang Province Department of Interventional Radiology and Vascular Surgery,The Second Affiliated Hospital of Hainan Medical University Department of Radiology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine Department of Intervention,The First Affiliated Hospital of Soochow University Longwan Interventional and Vascular Surgery,Huludao Central Hospital,Huludao Department of Intervention,Ningbo Medical Center Lihuili Hospital Department of Gastroenterology,People's Hospital of Rizhao Department of Gastroenterology,Yangquan Third People's Hospital,Yangquan Department of Infectious Diseases,Taihe Hospital,Shiyan City,Hubei Province Department of Interventional Therapy,Guilin People's Hospital,Guangxi Interventional Vascular Surgery,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia Department of Interventional Therapy,Yantai Yuhuangding Hospital Affiliated to Qingdao University Department of Radiology,Tongji Hospital Department of General Surgery,Donggang Campus,The First Hospital of Lanzhou University,Lanzhou Department of Gastroenterology,The Second Affiliated Hospital of Nanchang University,Nanchang Liver Disease Digestion Center,Beijing You'an Hospital,Capital Medical University Department of Radiology,Tianjin Second People's Hospital Department of Intervention,The Third Affiliated Hospital,Sun Yat‐sen University Second Department of Hepatology,Shenzhen Third People's Hospital Department of Interventional Radiology,The Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia Department of Intervention,Zigong Fourth People's Hospital Department of Hepatology,Jiamusi Infectious Disease Hospital,Jiamusi Department of Gastroenterology,Wuhan NO.1 Hospital Interventional Vascular Surgery,Jingzhou First People's Hospital,Jingzhou Interventional Diagnosis and Treatment Center,Lishui Central Hospital Department of Oncological and Vascular Intervention,First Hospital of Shanxi Medical University,Taiyuan Department of Interventional Radiology,People's Hospital of Tibet Autonomous Region Department of Intervention Tumor,The First Affiliated Hospital of University of Science and Technology of China Department of Interventional Radiology,The First Affiliated Hospital,Sun Yatsen University Department of Infectious Diseases,Qufu People's Hospital Interventional and Vascular Surgery,Zhongda Hospital Southeast University Department of Minimally Invasive Intervention,The Second Affiliated Hospital of Guangdong Medical University Department of Gastroenterology,The Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology Tumor and Vascular Intervention Department,Jinhua Medical Central Hospital Department of Infectious Diseases,The First Affiliated Hospital of Nanchang University,Nanchang Department of Gastroenterology,General Hospital of Ningxia Medical University,Yinchuan,Ningxia Interventional Diagnosis and Treatment Center,Zhoushan Hospital of Zhejiang Province,Zhoushan Department of Interventional Vascular Surgery,The Fifth Affiliated Hospital of Sun Yat‐sen University Department of Interventional Medicine,Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou Department of Hepatobiliary,Pancreatic,and Splenic Surgery,Shunde Hospital of Southern Medical University Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University Department of Hepatobiliary Medicine,The 900th Hospital of the Joint Logistics Support Force Department of Gastroenterology,The Second People's Hospital of Fuyang City,Anhui Province Department of Infectious Diseases,The NO.2 Affiliated Hospital of Air Force Medical University,Shaanxi Department of Gastroenterology,Weinan Central Hospital,Shaanxi Interventional Treatment Center,The First Affiliated Hospital of Xinjiang Medical University,Xinjiang Endovascular Surgery,The First Affiliated Hospital of Zhengzhou University Department of Interventional Therapy,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi Comprehensive Intervention Department,Hainan General Hospital Department of Gastroenterology,Kuitun Hospital,Xinjiang Department of Interventional Therapy,The First Affiliated Hospital of Dalian Medical University Department of Intervention,Sanming First Hospital Affiliated to Fujian Medical University,Sanming Department of Gastroenterology,Hospital of the People's Government of Tibet Autonomous Region in Chengdu Office Department of Gastroenterology,Fuling Hospital Affiliated to Chongqing University Department of Radiology,Mengzi People's Hospital Department of Gastroenterology,The Third People's Hospital of Mianyang,Mianyang Department of Gastroenterology,Shannan People's Hospital,Shannan Department of Gastroenterology,Hainan Hospital of Chinese PLA General Hospital Department of Intervention,The Second People's Hospital of Lanzhou City,Lanzhou Department of Vascular and Intervention,Nanfang Hospital of Southern Medical University Department of Interventional Radiology,The Affiliated Hospital of Jiangsu University,Zhenjiang
- 出处 《Portal Hypertension & Cirrhosis》 2024年第2期116-123,共8页
- 摘要 Aims:Surveys and research on the applications of the hepatic venous pressure gradient(HVPG)are important for understanding the current status and future development of this technology in China.This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022.Methods:We investigated the overall status of HVPG technology in China-including hospital distribution,hospital level,annual number of cases,catheters used,average cost,indications,and current challenges by using online questionnaire.By counting the number and percentages of cases of these results,we hope to clarify the current status of HVPG measurements in China.Results:According to the survey,85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces.A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022,of which 2813 cases(56.4%)were measured alone.The average cost of HVPG measurement was 5646.8±2327.9 CNY.Of the clinical teams who performed the measurements(sometimes multiple per hospital),94.3%(82/87)used the balloon method,and the majority of the teams(72.4%,63/87)used embolectomy catheters.Conclusions:This survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology.It is still necessary to continue promoting and popularizing this technology in the future.
- 关键词 application status hepatic vein pressure gradient questionnaire survey
- 分类号 R575.2 [医药卫生—消化系统]
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