Chapman R W, Forman D, Peto R, Smallwood R
Department of Gastroenterology, John Radcliffe Hospital, Oxford, UK.
Lancet. 1990 Jan 6;335(8680):32-5. doi: 10.1016/0140-6736(90)90150-4.
In the absence of definitive medical treatment for severe fulminant hepatic failure, liver transplantation may be appropriate in selected patients. However, uniform and easily applicable criteria for diagnosis of severity and analysis of results are needed to prevent unnecessary transplantation and to ensure that patients who may benefit are appropriately treated. Previous regimens for treatment of fulminant hepatic failure were often advocated, on the basis of data from historical controls, for several years until controlled trials failed to show any benefit. To obtain reliable information more rapidly than achieved before, a controlled trial between specialist liver transplant units is needed to establish the role of emergency hepatic transplantation in patients with fulminant hepatic failure.
在缺乏针对严重暴发性肝衰竭的确切药物治疗方法的情况下,对于部分选定的患者,肝移植可能是合适的治疗手段。然而,需要统一且易于应用的严重程度诊断标准和结果分析标准,以避免不必要的移植,并确保可能受益的患者得到恰当治疗。以往基于历史对照数据倡导的暴发性肝衰竭治疗方案,曾被沿用数年,直到对照试验未能显示出任何益处。为了比以往更快地获得可靠信息,需要在专业肝移植单位之间开展对照试验,以确定急诊肝移植在暴发性肝衰竭患者中的作用。