Faenza S, Arpesella G, Bernardi E, Faenza A, Pierucci E, Siniscalchi A, Zanoni A, Pinna A D
Dipartimento di Scienze Chirurgiche, Ranimatorie e dei Trapianti, Università degli Studi di Bologna, Italy.
Transplant Proc. 2006 May;38(4):1114-7. doi: 10.1016/j.transproceed.2006.02.018.
Combined transplants with the liver represent a small number of associated pathologies with little chance of resolving with a single transplant. The small case number prevents us from establishing homogeneous criteria for the procedure. The insertion of the Model for End-Stage Liver Disease in the preoperative evaluation of the patients awaiting liver transplant has definitely increased the number of combined liver-kidney transplants, which have reached more significant numbers. The number of heart-liver transplants is still too low to establish the efficacy of the measure. The multiorgan transplant with the liver represents a rare event entrusted to a series of case reports, each one of which has a history unto itself. Our experience in this field includes 14 combined liver-kidney, six combined heart-liver, and two multiorgan transplants with liver among 36 intestine transplants. We have examined the main pre-, intra-, and postsurgical problems for each one of these transplants, particularly relating to the anesthetic and intensive-care aspects.
肝联合移植存在少量相关病理情况，单一移植解决这些问题的可能性很小。病例数量少使得我们无法为该手术制定统一的标准。在等待肝移植患者的术前评估中加入终末期肝病模型，无疑增加了肝肾联合移植的数量，其数量已相当可观。心-肝移植的数量仍然太少，无法确定该措施的疗效。肝多器官移植是一个罕见事件，只能依靠一系列病例报告，每个病例都有其自身的病史。我们在这一领域的经验包括36例小肠移植中有14例肝肾联合移植、6例心-肝联合移植以及2例肝多器官移植。我们已经研究了这些移植手术中每一种的主要术前、术中和术后问题，特别是与麻醉和重症监护方面相关的问题。
