Darius T, Monbaliu D, Aerts R, Laleman W, Roskams T, Van Steenbergen W, Cassiman D, Verslype C, Maleux G, Nevens F, Pirenne J
Department of Abdominal Transplant Surgery, University Hospitals Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Transplant Proc. 2009 Oct;41(8):3427-9. doi: 10.1016/j.transproceed.2009.09.018.
A 53-year-old man with alcoholic liver cirrhosis underwent orthotopic liver transplantation (OLT) using a marginal graft. Persistent cholestasis post-OLT was successfully treated using a molecular adsorbent recirculating system (MARS). Afterwards, the patient developed refractory ascites, which was controlled by a transjugular intrahepatic portosystemic shunt (TIPS). TIPS reduction and eventually occlusion was necessary due to the development of encephalopathy. Despite TIPS occlusion, the ascites did not relapse probably because of the onset of other adaptive mechanisms. MARS and TIPS used sequentially were capable of rescuing a liver graft, thereby avoiding the morbidity and mortality associated with early retransplantation and sparing a liver graft from the donor pool.
一名患有酒精性肝硬化的53岁男性接受了使用边缘供肝的原位肝移植（OLT）。OLT术后持续胆汁淤积通过分子吸附循环系统（MARS）成功治疗。之后，患者出现难治性腹水，通过经颈静脉肝内门体分流术（TIPS）得到控制。由于发生脑病，有必要减少并最终闭塞TIPS。尽管TIPS闭塞，但腹水未复发，可能是因为其他适应性机制的出现。序贯使用MARS和TIPS能够挽救肝移植，从而避免与早期再次移植相关的发病率和死亡率，并使供肝库中的一个肝移植得以保留。
