Choudhary Narendra S, Saigal Sanjiv, Saraf Neeraj, Soin Arvinder S
Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta The Medicity, Gurugram, Delhi (NCR), India.
J Clin Exp Hepatol. 2020 Mar-Apr;10(2):170-176. doi: 10.1016/j.jceh.2019.07.009. Epub 2019 Jul 25.
Acute liver failure (ALF) is a catastrophic illness, which is associated with high mortality in absence of liver transplantation. ALF is associated with multisystem involvement including acute kidney injury (AKI). AKI worsens the already poor prognosis of ALF. There is limited literature on impact of AKI on outcomes of liver transplantation (LT). The use of continuous renal replacement therapy (CRRT) may have a role in transplant-free survival or bridging to LT. Although results suggest a somewhat lower survival in patients with ALF and AKI, LT is a life-saving option and should not be deferred in absence of other contraindications. In the current review, we discuss impact of AKI on transplant-free survival, possible role of CRRT, and role of LT in patients with ALF associated with AKI.
急性肝衰竭（ALF）是一种灾难性疾病，在没有肝移植的情况下死亡率很高。ALF与多系统受累有关，包括急性肾损伤（AKI）。AKI会使ALF本就不佳的预后更加恶化。关于AKI对肝移植（LT）结局影响的文献有限。连续性肾脏替代疗法（CRRT）的使用可能在无移植生存或过渡到肝移植方面发挥作用。尽管结果表明，ALF合并AKI患者的生存率略低，但肝移植是一种挽救生命的选择，在没有其他禁忌症的情况下不应推迟。在本综述中，我们讨论了AKI对无移植生存的影响、CRRT的可能作用以及肝移植在合并AKI的ALF患者中的作用。
