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[肝移植术后并发症管理。通过标准化方法和跨学科合作提高患者安全性]

[Complication management after liver transplantation. Increasing patient safety by standardized approach and interdisciplinary cooperation].

作者信息

Houben P, Gotthardt D N, Radeleff B, Sauer P, Büchler M W, Schemmer P

机构信息

Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, Kirschnerstr. 1, 69120, Heidelberg, Deutschland.

出版信息

Chirurg. 2015 Feb;86(2):139-45. doi: 10.1007/s00104-014-2883-y.

Abstract

The interdisciplinary management of postoperative complications in liver transplantation is of extreme importance. Due to organ shortage and prioritization of the most severely ill recipients in the model for end-stage liver disease (MELD)-based allocation, both donor and recipient associated morbidity are increasing. An interdisciplinary, structured monitoring concept is essential for the timely identification and specific treatment of postoperative complications. Interdisciplinary clinical rounds, laboratory testing and Doppler ultrasound monitoring of the graft perfusion are as important as comprehensive anti-infection prophylaxis and immunosuppression. Arterial perfusion disorders of any kind, biliary complications and postoperative fluid accumulation demand individualized therapeutic concepts. In summary, the success of liver transplantation depends on the communication and coordinated interdisciplinary cooperation of all disciplines involved.

摘要

肝移植术后并发症的多学科管理极其重要。由于器官短缺以及在基于终末期肝病模型(MELD)的分配中优先考虑病情最严重的受者,供体和受者相关的发病率都在上升。一个多学科、结构化的监测概念对于及时识别和特异性治疗术后并发症至关重要。多学科临床查房、实验室检查以及对移植物灌注的多普勒超声监测与全面的抗感染预防和免疫抑制同样重要。任何类型的动脉灌注障碍、胆道并发症和术后积液都需要个体化的治疗方案。总之,肝移植的成功取决于所有相关学科之间的沟通和协调的多学科合作。

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