McCaughan G W, Dorney S F, Gallagher N D, Painter D M, Vickery R, Kyd G, Rickard K, Bookallil M, Waugh R, Thompson J F
Royal Prince Alfred Hospital, NSW.
Aust N Z J Med. 1989 Apr;19(2):132-7. doi: 10.1111/j.1445-5994.1989.tb00222.x.
One hundred patients were referred to the Australian National Liver Transplantation Unit between January 1986 and August 1987. The commonest disorders for referral were chronic active hepatitis in adults (22 cases), fulminant hepatic failure (14), primary biliary cirrhosis (PBC) (12) and primary sclerosing cholangitis (PSC) (10). Of the 100 patients 31 were activated for transplantation while 35 were deferred and 34 were found to be unsuitable. The decision-making in these patients is discussed according to disease category. Timing of transplantation in PBC and PSC seemed clearcut, with 50% of referred patients being activated. However, major difficulties in timing of transplantation were found, particularly in patients with chronic active hepatitis (CAH) and fulminant hepatic failure (FHF). Of 36 patients with CAH (22) or FHF (14) only five were put on the active waiting list and only two were transplanted. Overall, 25 of the 31 patients underwent orthotopic liver transplantation, with 16 alive two-30 months later.
1986年1月至1987年8月期间，有100名患者被转诊至澳大利亚国家肝移植中心。转诊的最常见疾病是成人慢性活动性肝炎（22例）、暴发性肝衰竭（14例）、原发性胆汁性肝硬化（PBC）（12例）和原发性硬化性胆管炎（PSC）（10例）。在这100名患者中，31名被列入移植激活名单，35名被推迟，34名被认定不适合移植。本文根据疾病类别讨论了这些患者的决策过程。PBC和PSC患者的移植时机似乎比较明确，50%的转诊患者被列入移植激活名单。然而，发现移植时机存在重大困难，尤其是在慢性活动性肝炎（CAH）和暴发性肝衰竭（FHF）患者中。在36例CAH（22例）或FHF（14例）患者中，只有5名被列入移植激活等待名单，只有2名接受了移植。总体而言，31名患者中有25名接受了原位肝移植，其中16名在术后2至30个月存活。
