Department of Gastroenterology and Hepatology, PACE Hospitals, Hitec City, Hyderabad, India.
Hepatology and Liver Transplant, Centre for Liver & Biliary Sciences, Centre of Gastroenterology, Hepatology & Endoscopy, Max Super Speciality Hospital, Saket, New Delhi, India.
Liver Transpl. 2023 Aug 1;29(8):871-884. doi: 10.1097/LVT.0000000000000173. Epub 2023 May 11.
Early allograft dysfunction (EAD) after liver transplantation is a significant clinical problem that negatively impacts graft and patient outcomes. The rising incidence of EAD and what it means concerning living donor liver transplantation (LDLT) is an area of great interest. However, EAD after LDLT is a complex research topic yet to be reviewed comprehensively. Most of the literature on EAD is based on experience in deceased donor liver transplantation, and limited information is available in the context of LDLT. Thus, in this review, we present an overview of EAD after LDLT and have attempted to present balanced points of view on all its aspects, such as definitions, pathogenesis, risk factors, predictive markers, and management. The review aims to broadly overview the nature and extent of ongoing research evidence on this complex topic and inform practice in the field by identifying key concepts and knowledge gaps and highlighting areas that require further inquiry.
肝移植后早期移植物功能障碍(EAD)是一个重大的临床问题,对移植物和患者预后产生负面影响。EAD 的发病率不断上升,以及这对活体供肝移植(LDLT)意味着什么,是一个非常关注的领域。然而,LDLT 后 EAD 是一个尚未得到全面综述的复杂研究课题。大多数关于 EAD 的文献都是基于对已故供体肝移植的经验,而在 LDLT 背景下,相关信息有限。因此,在本综述中,我们介绍了 LDLT 后 EAD 的概述,并试图就其所有方面,如定义、发病机制、危险因素、预测标志物和管理,提出平衡的观点。本综述旨在广泛概述这一复杂主题的现有研究证据的性质和程度,并通过确定关键概念和知识空白,以及突出需要进一步研究的领域,为该领域的实践提供信息。