Matsunami H, Shimizu Y, Shimizu A, Horita K, Yamakita N, Ikeda T
Department of Surgery, Matsunami General Hospital, Hashima-gun Gifu-pref. 501-6062.
Rinsho Byori. 2000 Nov;48(11):993-1005.
Survival rate of liver transplanted patients is depending on management of postoperative complications. These complications include technical problems related to the operation, dysfunction of the allograft, and variety of medical complications. Differentiating and appropriately managing these diverse complications is a formidable challenge. Given the complexity of liver transplantation, it is not surprising that a variety of technical complication can occur following the operation. The most prominent of these include intraabdominal bleeding, hepatic artery thrombosis, portal vein thrombosis, and obstruction of or leak from the biliary anastomosis. In addition to these technical complications, each of which can result in dysfunction of the graft, there are a number of intrahepatic causes of graft dysfunction. The most common of these are allograft rejection, viral hepatitis and non-specific postoperative jaundice. In living related liver transplantation, primary graft non-function is rare. Accurate diagnosis and management of the various causes of graft dysfunction, whether intrahepatic or extrahepatic in origin, is very important.
肝移植患者的生存率取决于术后并发症的处理。这些并发症包括与手术相关的技术问题、同种异体移植物功能障碍以及各种医学并发症。鉴别并妥善处理这些不同的并发症是一项艰巨的挑战。鉴于肝移植的复杂性,术后出现各种技术并发症并不奇怪。其中最突出的包括腹腔内出血、肝动脉血栓形成、门静脉血栓形成以及胆管吻合口梗阻或渗漏。除了这些可导致移植物功能障碍的技术并发症外,还有许多肝内原因可导致移植物功能障碍。其中最常见的是同种异体移植物排斥反应、病毒性肝炎和非特异性术后黄疸。在活体亲属肝移植中,原发性移植物无功能很少见。准确诊断和处理移植物功能障碍的各种原因,无论其起源于肝内还是肝外,都非常重要。