Dehne S, Lund F, Larmann J, Schmidt K, Brenner T, Weigand M A, von Haken R
Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
Anaesthesist. 2019 Jun;68(6):403-418. doi: 10.1007/s00101-019-0595-x.
Liver transplantation (LTPL) is the only curative option for patients with end stage liver disease (ESLD) or with hepatocellular carcinoma (HCC). Eurotransplant in Leiden, the Netherlands, is responsible for organ allocation. The model of end stage liver disease (MELD) score, which describes the severity of the liver disease, is decisive for organ allocation. The heterogeneous patient collective and hepatic-related comorbidities and their dynamics represent challenges. The anesthesiologist is responsible for evaluating the overall prognosis, whereby cardiac, pulmonary, renal and neurological comorbidities must be taken into consideration. During LTPL surgery is divided into several stages. Besides volume management, heat preservation and coagulation management, major challenges for the anesthesiologist are hemodynamic stabilization and regulation of the acid-base balance.
肝移植（LTPL）是终末期肝病（ESLD）或肝细胞癌（HCC）患者的唯一治愈选择。位于荷兰莱顿的欧洲移植组织负责器官分配。终末期肝病模型（MELD）评分描述了肝病的严重程度，对器官分配起决定性作用。患者群体的异质性以及肝脏相关的合并症及其动态变化构成了挑战。麻醉医生负责评估总体预后，必须考虑心脏、肺部、肾脏和神经方面的合并症。在肝移植手术过程中分为几个阶段。除了容量管理、保温和凝血管理外，麻醉医生面临的主要挑战是血流动力学稳定和酸碱平衡的调节。
