Zarrinpar Ali, Hong Johnny C
Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, 650 C. E. Young Drive South, 77-120 CHS, Box 957054, Los Angeles, CA 90095, USA.
Adv Surg. 2012;46:87-100. doi: 10.1016/j.yasu.2012.03.005.
In patients with failing liver grafts, hepatic retransplantation cannot be abandoned for the ethical and practical reasons that have been detailed previously. The current recommendations involve a strategy for risk stratification of retransplant candidates. The long-term patient and graft survival outcomes after ReLT are excellent and acceptable for the low and intermediate groups, respectively. However, pursuing ReLT in transplant candidates in the high-risk category cannot be recommended. Furthermore, ReLT should be reserved for centers equipped to manage the difficulties of the endeavor because it is a technically demanding operation that requires surgical expertise and excellent anesthesiology and critical care support both before and after transplantation.
对于肝移植失败的患者，出于先前详述的伦理和实际原因，不能放弃再次肝移植。目前的建议包括对再次移植候选者进行风险分层的策略。对于低风险和中等风险组，再次肝移植术后患者和移植物的长期生存结果分别是优异的和可接受的。然而，不建议对高风险类别的移植候选者进行再次肝移植。此外，再次肝移植应保留给有能力应对该手术困难的中心，因为这是一项技术要求很高的手术，术前和术后都需要外科专业知识以及出色的麻醉和重症监护支持。
