Langnas A N, Grazi G L, Stratta R J, Wood R P, Marujo W, Markin R S, Donovan J, Burnett D, Zetterman R, Sorrell M
Department of Surgery, University of Nebraska Medical Center, Omaha.
Am J Gastroenterol. 1990 Sep;85(9):1136-41.
Primary sclerosing cholangitis is a progressive liver disease for which orthotopic liver transplantation is the only curative procedure. Questions exist regarding the role of temporizing procedures and the timing of transplantation. During the past 4 yr, we have performed liver transplants in 177 adult recipients. Twenty-six patients (14.6%) with primary sclerosing cholangitis received 30 transplants including 12 men and 14 women. The recipients were examined for a number of preoperative and postoperative variables. The 4-yr actuarial survival in patients with primary sclerosing cholangitis after transplantation was 88%. Patients were segregated according to preoperative risk variables. Twenty patients were low and medium risk, with one death (95% survival). Three patients were high risk, with two deaths (33% survival). In conclusion, orthotopic liver transplantation is safe and effective therapy for primary sclerosing cholangitis. Early referral for transplantation is recommended to reduce the mortality associated with this procedure in those with advanced hepatic failure.
原发性硬化性胆管炎是一种进行性肝病，原位肝移植是唯一的治愈方法。关于过渡性手术的作用和移植时机存在一些问题。在过去4年中，我们对177名成年受者进行了肝移植。26例（14.6%）原发性硬化性胆管炎患者接受了30次移植，其中男性12例，女性14例。对受者进行了多项术前和术后变量检查。移植后原发性硬化性胆管炎患者的4年实际生存率为88%。根据术前风险变量对患者进行分类。20例为低风险和中等风险，1例死亡（生存率95%）。3例为高风险，2例死亡（生存率33%）。总之，原位肝移植是治疗原发性硬化性胆管炎的安全有效的方法。建议早期转诊进行移植，以降低晚期肝衰竭患者在此手术中的死亡率。
