Sharma Pratima, Bari Khurram
Division of Gastroenterology, University of Michigan, Ann Arbor, MI; Division of Gastroenterology, University of Cincinnati, Cincinnati, OH.
Division of Gastroenterology, University of Michigan, Ann Arbor, MI; Division of Gastroenterology, University of Cincinnati, Cincinnati, OH.
Adv Chronic Kidney Dis. 2015 Sep;22(5):404-11. doi: 10.1053/j.ackd.2015.06.001.
Liver transplantation is the standard of care for patients with decompensated cirrhosis. Liver transplantation recipients have excellent short-term and long-term outcomes including patient and graft survival. Since the adoption of model for end-stage liver disease (MELD)-based allocation policy, the incidence of post-transplant end stage renal disease has risen significantly. Occurrence of Stage 4 chronic kidney disease and end stage renal disease substantially increases the risk of post-transplant deaths. Because majority of late post-transplant mortality is due to nonhepatic post-transplant comorbidities, personalized care directed toward risk factor modification may further improve post-transplant survival.
肝移植是失代偿期肝硬化患者的标准治疗方法。肝移植受者具有良好的短期和长期预后,包括患者生存率和移植物存活率。自采用基于终末期肝病模型(MELD)的分配政策以来,移植后终末期肾病的发生率显著上升。4期慢性肾病和终末期肾病的发生大幅增加了移植后死亡风险。由于移植后期死亡大多归因于移植后非肝脏合并症,针对危险因素调整的个性化护理可能进一步提高移植后的生存率。