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[外科手术与器官移植]

[Surgery and organ transplantation].

作者信息

Kalmuk S, Neuhaus P, Pascher A

机构信息

Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charite - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland,

出版信息

Chirurg. 2013 Nov;84(11):937-44. doi: 10.1007/s00104-013-2514-z.

DOI:10.1007/s00104-013-2514-z
PMID:24071973
Abstract

Liver and kidney transplantations have been performed for almost 50 years and is nowadays a routine procedure for the treatment of terminal liver failure and terminal-stage renal failure. Under given optimal conditions and increasing experience good results can be achieved. Improvements in surgical techniques have led to a decrease in the incidence of surgical complications after transplantation. Nevertheless after liver and kidney transplantation complications can occur and increase the morbidity and mortality. There are a number of possible complications which range from harmless wound healing disorders to severe vascular, biliary or urinary complications that can be associated with graft dysfunction and lead to graft loss. In order to identify risk factors preoperatively and achieve good outcome after transplantation a good preparation of the recipients is necessary. Furthermore, a good interdisciplinary cooperation is necessary both to recognize complications early and to treat these adequately.

摘要

肝脏和肾脏移植已经开展了近50年,如今已成为治疗终末期肝衰竭和终末期肾衰竭的常规手术。在给定的最佳条件下以及经验不断增加的情况下,可以取得良好的效果。手术技术的改进导致移植后手术并发症的发生率降低。然而,肝移植和肾移植后仍可能出现并发症,从而增加发病率和死亡率。有许多可能的并发症,从无害的伤口愈合障碍到严重的血管、胆道或泌尿系统并发症,这些并发症可能与移植物功能障碍相关并导致移植物丢失。为了术前识别危险因素并在移植后取得良好的结果,对受者进行充分的准备是必要的。此外,为了早期识别并发症并进行充分治疗,良好的多学科合作是必要的。

相似文献

1
[Surgery and organ transplantation].[外科手术与器官移植]
Chirurg. 2013 Nov;84(11):937-44. doi: 10.1007/s00104-013-2514-z.
2
Atypical calcineurin inhibitor-induced haemolytic uremic syndrome after liver transplantation.肝移植后非典型钙调神经磷酸酶抑制剂诱导的溶血性尿毒症综合征
Ann Transplant. 2009 Oct-Dec;14(4):47-51.
3
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Clin Transplant. 2018 Jan;32(1). doi: 10.1111/ctr.13148. Epub 2017 Nov 24.
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Ann Surg. 2017 May;265(5):1016-1024. doi: 10.1097/SLA.0000000000001801.
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Cyclosporine-induced migraine with severe vomiting causing loss of renal graft.环孢素诱发的偏头痛伴严重呕吐导致肾移植失败。
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Cumulative incidence, indications, morbidity and mortality of transplant nephrectomy and the most appropriate time for graft removal: only nonfunctioning transplants that cause intractable complications should be excised.移植肾切除术的累积发病率、适应证、发病率和死亡率以及最合适的移植物切除时间:仅应切除导致顽固性并发症的无功能移植物。
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[Combined liver-kidney and kidney after liver transplantation: indications and experiences from a nephrological perspective at a single center].[肝移植后肝肾联合移植与肾移植:单中心肾脏病学视角的指征与经验]
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Irreversible Graft Failure Requiring 3 Repeated Liver Transplantations Combined With a 2-Stage Liver Transplantation: A Case Report.不可逆性移植物衰竭需3次重复肝移植联合两阶段肝移植:1例病例报告
Transplant Proc. 2016 Jan-Feb;48(1):242-6. doi: 10.1016/j.transproceed.2015.11.011.

本文引用的文献

1
Unexpected colonic perforation in a renal recipient: a case report.肾移植受者发生意外结肠穿孔:一例报告
Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):65-8. doi: 10.5505/tjtes.2013.53496.
2
Risk factors for surgical complications after renal transplantation and impact on patient and graft survival.肾移植术后手术并发症的危险因素及其对患者和移植物存活的影响。
Transplant Proc. 2012 Nov;44(9):2803-8. doi: 10.1016/j.transproceed.2012.09.030.
3
Posttransplant malignancies in solid organ adult recipients: an analysis of the U.S. National Transplant Database.
实体器官成人受者移植后恶性肿瘤:美国国家移植数据库分析。
Transplantation. 2012 Nov 27;94(10):990-8. doi: 10.1097/TP.0b013e318270bc7b.
4
Late recurrence of hepatocellular carcinoma after liver transplantation: is an active surveillance for recurrence needed?肝移植后肝细胞癌的晚期复发:是否需要对复发进行主动监测?
Transplant Proc. 2012 Jul-Aug;44(6):1565-7. doi: 10.1016/j.transproceed.2012.05.007.
5
Recipient and donor risk factors for surgical complications following kidney transplantation.肾移植术后手术并发症的受者和供者风险因素。
Scand J Urol. 2013 Feb;47(1):63-71. doi: 10.3109/00365599.2012.700945. Epub 2012 Jul 10.
6
Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR).欧洲肝移植的适应证演变与结果。欧洲肝移植登记处(ELTR)的报告。
J Hepatol. 2012 Sep;57(3):675-88. doi: 10.1016/j.jhep.2012.04.015. Epub 2012 May 16.
7
Long-term results of liver transplantation.肝移植的长期效果。
Scand J Surg. 2011;100(1):14-21. doi: 10.1177/145749691110000104.
8
Progression to adenocarcinoma in Barrett's esophagus after liver transplantation.肝移植后 Barrett 食管腺癌的进展。
Transplantation. 2011 Jun 15;91(11):1250-3. doi: 10.1097/TP.0b013e31821841a0.
9
Vascular complications after orthotopic liver transplantation: hepatic artery thrombosis.原位肝移植后的血管并发症:肝动脉血栓形成
Transplant Proc. 2010 Oct;42(8):2970-2. doi: 10.1016/j.transproceed.2010.07.063.
10
Comparison of the incidence of malignancy in recipients of different types of organ: a UK Registry audit.不同类型器官受者恶性肿瘤发病率的比较:英国登记处审计。
Am J Transplant. 2010 Aug;10(8):1889-96. doi: 10.1111/j.1600-6143.2010.03181.x.