Biancofiore Gianni, Davis Connie L
Liver Anesthesia and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, Cisanello Hospital, Pisa, Italy.
Curr Opin Organ Transplant. 2008 Jun;13(3):291-7. doi: 10.1097/MOT.0b013e328300a058.
Acute kidney failure in the perioperative liver transplant recipients results in an increased hospital length of stay, acute rejection, infection rate and overall mortality. Thus, it is of great importance to be able to recognize, prevent and treat kidney injury.
Immediate post liver transplant kidney dysfunction is increased in those with pretransplant kidney failure, hepato-renal syndrome, intraoperative hypotension, intraoperative hypovolemia, aprotinin use and those requiring transfusion of more units of blood products or needing to return to the operating room.
To date, avoiding risky clinical situations, maintaining homeostasis and a multidisciplinary approach to care have been reasonable approaches to decrease the incidence of postoperative acute kidney injury.
围手术期肝移植受者发生急性肾衰竭会导致住院时间延长、急性排斥反应、感染率及总体死亡率增加。因此,能够识别、预防和治疗肾损伤至关重要。
肝移植术后即刻出现肾功能障碍的情况在移植前存在肾衰竭、肝肾综合征、术中低血压、术中低血容量、使用抑肽酶以及需要输注更多单位血液制品或需要返回手术室的患者中更为常见。
迄今为止,避免危险的临床情况、维持内环境稳定以及采用多学科护理方法一直是降低术后急性肾损伤发生率的合理方法。