From the Division of Transplantation, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Exp Clin Transplant. 2022 Jun;20(6):609-612. doi: 10.6002/ect.2019.0313. Epub 2020 Feb 7.
Patients with glycogen storage diseases pose unique management challenges to clinicians.These challenges are exacerbated wheneverthey undergo surgery as the basic anomaly in their glycogen storage pathways make them susceptible to organic acidosis, which may in turn complicate their preoperative, intraoperative, and postoperative course. Because of the rarity of these diseases, clinicians may not be aware of the specific management concerns. In the case reported here, a 37-year-old patient with glycogen storage disease type 1 underwentleft hepatectomy for hepatic adenomatosis, which was complicated by intraoperative severe lactic acidosis that was successfully treated. After successful hepatectomy, the patient underwent liver transplant without major lactic acidosis or hemodynamic instability. Early recognition and aggressive management of blood sugar and lactic acidosis in patients with glycogen storage diseases can allow for successful outcomes even when complex surgical procedures are required.
糖原贮积病患者给临床医生带来了独特的管理挑战。当他们接受手术时,这些挑战会更加严重,因为他们的糖原储存途径中的基本异常使他们容易发生有机酸血症,这反过来又可能使他们的术前、术中和术后过程复杂化。由于这些疾病罕见,临床医生可能不知道具体的管理问题。在本报告的病例中,一名 37 岁的糖原贮积病 1 型患者因肝腺瘤病接受左肝切除术,术中发生严重乳酸酸中毒,经成功治疗。肝切除术后,患者在无严重乳酸酸中毒或血流动力学不稳定的情况下接受肝移植。即使需要复杂的手术程序,早期识别和积极管理糖原贮积病患者的血糖和乳酸酸中毒也可以实现成功的治疗结果。