Rosenthal P
Pediatric Liver Transplant Program, Department of Pediatric Hepatology, University of California, San Francisco, 500 Parnassus Avenue, Box 0136, MU 4-East, San Francisco, CA 94143-0136, USA.
Curr Gastroenterol Rep. 2000 Feb;2(1):55-60. doi: 10.1007/s11894-000-0052-6.
Patients with fulminant hepatic failure fall into two categories: those who will not recover without hepatic replacement, and those with severe but potentially reversible liver injury whose livers have the potential to recover and/or regenerate. Liver support systems must provide physiologic support, rendering the patient hemodynamically stable and "bridging" the patient to transplantation, or allowing the native liver to recover and/or regenerate. Recent limited successes with bioartificial liver support for patients with fulminant liver failure are encouraging. However, these preliminary results come without randomization or control groups and without stratification by disease etiology or severity. It is hoped that randomized, controlled trials will answer important questions about the efficacy of these systems.
一类是不进行肝脏替代就无法康复的患者，另一类是肝脏损伤严重但有可能可逆、肝脏有恢复和/或再生潜力的患者。肝支持系统必须提供生理支持，使患者血流动力学稳定，“过渡”到移植阶段，或者让自身肝脏恢复和/或再生。近期生物人工肝支持用于暴发性肝衰竭患者取得的有限成功令人鼓舞。然而，这些初步结果缺乏随机分组或对照组，也未按疾病病因或严重程度进行分层。希望随机对照试验能解答有关这些系统疗效的重要问题。
