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巨大肝血管瘤的肝移植:一项系统评价

Liver Transplantation for Giant Hepatic Hemangioma: A Systematic Review.

作者信息

Prodromidou A, Machairas N, Garoufalia Z, Kostakis I D, Tsaparas P, Paspala A, Stamopoulos P, Sotiropoulos G C

机构信息

2nd Department of Propaedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

2nd Department of Propaedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; 3rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

出版信息

Transplant Proc. 2019 Mar;51(2):440-442. doi: 10.1016/j.transproceed.2019.01.018. Epub 2019 Jan 4.

Abstract

INTRODUCTION

Despite their benign nature, liver hemangiomas (LH) are lesions that can cause major complications requiring intervention. Liver transplantation (LT) has been suggested as an effective treatment option in selected patients with giant LHs causing severe symptoms and cannot be treated otherwise. The aim of our study was to investigate the indications, aspects and post-operative outcomes of patients with a LH who underwent LT.

MATERIALS AND METHODS

A meticulous search of the literature was performed. Studies presenting cases of LT due to LH were evaluated. Studies presenting patients characteristics and symptoms, aspects of the disease, transplantation indications and details were selected.

RESULTS

Fifteen studies were included in the present review that involved 16 patients. Among them, 4 were male while the remaining 12 were female with a mean age of 39.9 ± 8.7 years. The main indications for LT included respiratory distress, massive hemorrhage, Kasabach-Merritt syndrome, and unsuccessful previous treatment strategies. Four patients were transplanted from living donors and the remaining 12 from cadaveric donors. No post-operative deaths were reported and all patients returned to normal activity. No deaths during the long-term follow-up were reported.

CONCLUSIONS

LH is an extremely rare indication for LT. Nevertheless, the currently available data suggest that LT is a safe and efficient treatment in the management of symptomatic or complicated LH in selected patients.

摘要

引言

尽管肝血管瘤(LH)本质上是良性病变,但这些病变可能会引发需要干预的严重并发症。对于某些患有巨大肝血管瘤且出现严重症状、无法通过其他方式治疗的患者,肝移植(LT)已被视为一种有效的治疗选择。我们研究的目的是调查接受肝移植的肝血管瘤患者的适应症、相关情况及术后结果。

材料与方法

对文献进行了细致的检索。对因肝血管瘤进行肝移植的病例研究进行了评估。选取了呈现患者特征与症状、疾病相关情况、移植适应症及细节的研究。

结果

本综述纳入了15项研究,涉及16例患者。其中,男性4例,其余12例为女性,平均年龄为39.9±8.7岁。肝移植的主要适应症包括呼吸窘迫、大量出血、卡萨巴-梅里特综合征以及既往治疗策略失败。4例患者接受活体供体移植,其余12例接受尸体供体移植。未报告术后死亡情况,所有患者均恢复正常活动。长期随访期间也未报告死亡情况。

结论

肝血管瘤是肝移植极为罕见的适应症。然而,目前可得的数据表明,对于特定患者中出现症状或复杂的肝血管瘤,肝移植是一种安全有效的治疗方法。

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