Halliday Neil, Westbrook Rachel H
Wellcome Clinical Research Fellow, Institute of Immunity and Transplantation, University College London, London NW3 2PF.
Consultant Hepatologist, Sheila Sherlock Liver Centre, Royal Free Hospital NHS Trust, London.
Br J Hosp Med (Lond). 2017 May 2;78(5):252-259. doi: 10.12968/hmed.2017.78.5.252.
Chronic or acute liver failure and primary liver cancers can be effectively managed with liver transplantation. The range of indications for liver transplantation is increasing but there is a mismatch between the numbers of available donations and current needs. Specific criteria for listing patients exist but, at minimum, the predicted mortality without transplantation must exceed that with transplantation, coupled with a 50% predicted 5-year survival following liver transplantation. The risk posed by liver disease must be weighed against the risk of liver transplantation, considering the patient's comorbidities, age, nutritional status and behavioural factors in a complex assessment process. This article reviews current UK practice in the selection and care of patients being assessed for liver transplantation.
慢性或急性肝衰竭以及原发性肝癌可通过肝移植得到有效治疗。肝移植的适应证范围正在扩大，但可用捐赠数量与当前需求之间存在差距。存在患者列入移植名单的具体标准，但至少，预计未进行移植的死亡率必须超过移植后的死亡率，同时肝移植后预计5年生存率要达到50%。在一个复杂的评估过程中，必须权衡肝脏疾病带来的风险与肝移植的风险，同时要考虑患者的合并症、年龄、营养状况和行为因素。本文综述了英国目前在肝移植评估患者的选择和护理方面的做法。
