Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation CH-10, 200 First Street S.W. Rochester, MN 55905, USA.
Nat Rev Gastroenterol Hepatol. 2015 Nov;12(11):639-48. doi: 10.1038/nrgastro.2015.172. Epub 2015 Oct 13.
Improvements in overall survival early after liver transplantation result in a growing number of patients with the potential for long-term survival. Data available on long-term survival, to date, reflect the situation of patients who received their liver transplant during a very different health-care era. Translating these data into the current medical era of liver transplantation is an important task, as a better understanding of aspects associated with morbidity and mortality is fundamental in improving the long-term outcome of liver transplant recipients. Malignancy screening, optimal treatment of recurrent disease and adequate management of metabolic disease are crucial contributions to advance patient care. In this Review, data specific to the liver transplant recipient will be evaluated and, in the absence of sufficient evidence at this time, recommendations and guidelines for the general population on management of long-term concerns will be assessed for their applicability after liver transplantation. In addition, other preventive strategies relating to pregnancy, contraception and vaccination are reviewed in detail.
肝移植术后总体生存率的提高导致越来越多的患者具有长期生存的潜力。迄今为止，有关长期生存的数据反映了在非常不同的医疗保健时代接受肝移植的患者的情况。将这些数据转化为当前的肝移植医疗时代是一项重要任务，因为更好地了解与发病率和死亡率相关的方面对于改善肝移植受者的长期预后至关重要。恶性肿瘤筛查、复发性疾病的最佳治疗以及代谢性疾病的充分管理是提高患者护理水平的关键贡献。在这篇综述中，将评估特定于肝移植受者的数据，并且在目前缺乏充分证据的情况下，将评估针对一般人群的关于长期问题管理的建议和指南在肝移植后的适用性。此外，还详细回顾了与妊娠、避孕和疫苗接种有关的其他预防策略。
