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急性肝衰竭的肝移植

Liver transplantation for acute liver failure.

作者信息

Hessheimer Amelia J, Nacif Lucas, Flores Villalba Eduardo, Fondevila Constantino

机构信息

Liver Transplant Unit, Department of Surgery, Hospital Clínic, CIBERehd, University of Barcelona, Barcelona, España.

Liver Transplant Unit, Department of Surgery, Hospital Clínic, CIBERehd, University of Barcelona, Barcelona, España.

出版信息

Cir Esp. 2017 Apr;95(4):181-189. doi: 10.1016/j.ciresp.2017.01.008. Epub 2017 Apr 19.

Abstract

Before liver transplantation became widely applicable as a treatment option, the mortality rate for acute liver failure was as high as 85%. Today, acute liver failure is a relatively common transplant indication in some settings, but the results of liver transplantation in this context appear to be worse than those for chronic forms of liver disease. In this review, we discuss the indications and contraindications for urgent liver transplantation. In particular, we consider the roles of auxiliary, ABO-incompatible, and urgent living donor liver transplantation and address the management of a «status 1» patient with total hepatectomy and portocaval shunt for toxic liver syndrome.

摘要

在肝移植成为广泛适用的治疗选择之前,急性肝衰竭的死亡率高达85%。如今,在某些情况下,急性肝衰竭是一种相对常见的移植指征,但在此背景下肝移植的结果似乎比慢性肝病形式的结果更差。在本综述中,我们讨论紧急肝移植的适应证和禁忌证。特别是,我们考虑辅助性、ABO血型不相容和紧急活体供肝移植的作用,并探讨对因中毒性肝综合征接受全肝切除术和门腔分流术的“1级”患者的管理。

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