Elias E, McMaster P
Liver Unit, Queen Elizabeth Hospital, Birmingham, U.K.
Schweiz Med Wochenschr. 1987 Jul 18;117(29):1053-60.
Liver transplantation is now increasingly being accepted as a valuable and effective way of greatly improving not just the survival of patients with major hepatic disease but also their quality of life. Rehabilitation is excellent after liver replacement and if increasing success is to be achieved with greater numbers of young people rehabilitated an increasing awareness of the benefits should be matched by an early review and discussion in order to reduce the high proportion of patients still being referred for replacement in the agonal phase of their disease at a time when the morbidity and mortality of the procedure remains high. The balance between intervention which is "too early" or "too late" may for the individual patient be a difficult judgment but the benefits of making this correct clinical judgment is now undoubted. Liver replacement for advanced liver disease can no longer be considered an experimental undertaking now that so many of the technical issues have been resolved. Inevitably as in so many aspects of medicine the discussion will now concentrate on the timing of intervention rather than whether intervention itself should occur.
肝移植如今越来越被视为一种非常有价值且有效的方法，它不仅能显著提高患有严重肝脏疾病患者的生存率，还能提升他们的生活质量。肝脏置换术后康复效果良好。如果要在更多年轻人得到康复的情况下取得更大的成功，就应该通过早期评估和讨论来提高对这些益处的认识，以便减少仍在疾病濒死期才被转诊进行肝脏置换的患者比例，而此时该手术的发病率和死亡率仍然很高。对于个体患者而言，判断干预是“过早”还是“过晚”可能很困难，但做出正确临床判断的益处如今是毋庸置疑的。鉴于许多技术问题已经得到解决，晚期肝病的肝脏置换不再被视为一项试验性工作。不可避免地，就像医学的许多方面一样，现在的讨论将集中在干预的时机上，而不是干预本身是否应该进行。
