General Surgery 8 and Liver Transplantation Center, San Giovanni Battista - Molinette University Hospital, A. O. Città della Salute e della Scienza, Turin, Italy.
Clin Transplant. 2013 Jul-Aug;27(4):E528-37. doi: 10.1111/ctr.12192.
Severe hepatic trauma is a rare indication for liver transplantation (LT). We report our single-center experience of LT for hepatic trauma. Four new cases are discussed in light of a literature review in order to depict the pathways leading from hepatic trauma to LT and to assess the outcomes of this practice. LT is generally indicated in case of uncontrollable hemorrhage, acute liver failure, or post-traumatic late sequelae. Hepatic vessels thrombosis, sepsis, major hepatic resections, and a late referral are factors associated with the progression toward irreversible liver failure. Considering all reported cases, early patient and graft survival reached 68% and 62%, respectively, but in the last decade both have improved to 84%. LT after severe hepatic trauma is a sustainable practice considering the current good outcomes and the ineluctable death of these patients without LT.
严重肝外伤是肝移植（LT）的罕见适应证。我们报告了我们单中心的肝外伤 LT 经验。为了描述从肝外伤到 LT 的途径，并评估这种做法的结果，我们结合文献复习讨论了 4 个新病例。LT 通常适用于无法控制的出血、急性肝功能衰竭或创伤后晚期后遗症。肝血管血栓形成、脓毒症、大肝切除术和延迟转诊是导致不可逆性肝功能衰竭进展的相关因素。考虑到所有报告的病例，早期患者和移植物的存活率分别达到 68%和 62%，但在过去十年中，这两个数据都提高到了 84%。考虑到目前良好的结果和这些患者如果不进行 LT 将不可避免地死亡，严重肝外伤后的 LT 是一种可持续的实践。
