Lim Kieron B L, Schiano Thomas D
Mount Sinai School of Medicine, New York, NY, USA.
Mt Sinai J Med. 2012 Mar-Apr;79(2):169-89. doi: 10.1002/msj.21302.
Liver transplantation is a life-saving therapy for patients with end-stage liver disease, acute liver failure, and liver tumors. Over the past 4 decades, improvements in surgical techniques, peritransplant intensive care, and immunosuppressive regimens have resulted in significant improvements in short-term survival. Focus has now shifted to addressing long-term complications and improving quality of life in liver recipients. These include adverse effects of immunosuppression; recurrence of the primary liver disease; and management of diabetes, hypertension, dyslipidemia, obesity, metabolic syndrome, cardiovascular disease, renal dysfunction, osteoporosis, and de novo malignancy. Issues such as posttransplant depression, employment, sexual function, fertility, and pregnancy must not be overlooked, as they have a direct impact on the liver recipient's quality of life. This review summarizes the latest data in long-term outcome after liver transplantation.
肝移植是终末期肝病、急性肝衰竭和肝肿瘤患者的一种挽救生命的治疗方法。在过去40年里，手术技术、移植后重症监护和免疫抑制方案的改进使短期生存率有了显著提高。目前的重点已转向解决长期并发症并改善肝移植受者的生活质量。这些并发症包括免疫抑制的不良反应；原发性肝病的复发；以及糖尿病、高血压、血脂异常、肥胖、代谢综合征、心血管疾病、肾功能不全、骨质疏松和新发恶性肿瘤的管理。移植后抑郁、就业、性功能、生育能力和妊娠等问题也不容忽视，因为它们直接影响肝移植受者的生活质量。本综述总结了肝移植后长期预后的最新数据。
