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经导管主动脉瓣置换术恢复肝硬化患者肝移植的候选资格

Transcatheter Aortic Valve Replacement Restoring Candidacy for Liver Transplant in Patients With Cirrhosis.

作者信息

Kaafarani Mirna, Shamma Omar, Jafri Syed-Mohammed

机构信息

Wayne State University School of Medicine, Detroit, MI.

Department of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, MI.

出版信息

ACG Case Rep J. 2023 Aug 17;10(8):e01102. doi: 10.14309/crj.0000000000001102. eCollection 2023 Aug.

DOI:10.14309/crj.0000000000001102
PMID:37601302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10435020/
Abstract

Guidelines for preoperative workup for an orthotopic liver transplant often rule out patients with severe aortic stenosis as transplant candidates. This case illustrates the potential of transcatheter aortic valve replacement (TAVR) as a bridge for liver transplants in cirrhotic patients with severe aortic stenosis. The 1-year and 2-year post-liver transplant follow-ups showed no complications in the patient's prosthetic aortic valves, and graft survival was 100% with no evidence of rejection. Notable post-transplant recovery involved medical complications that were not related to the liver function or surgical procedure.

摘要

原位肝移植术前检查指南通常将严重主动脉瓣狭窄患者排除在移植候选者之外。本病例说明了经导管主动脉瓣置换术(TAVR)作为患有严重主动脉瓣狭窄的肝硬化患者肝移植桥梁的可能性。肝移植术后1年和2年的随访显示,患者的人工主动脉瓣无并发症,移植肝存活率为100%,无排斥反应迹象。值得注意的是,移植后的恢复涉及与肝功能或手术无关的医学并发症。

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本文引用的文献

1
Outcomes of transcatheter aortic valve replacement in end stage liver and renal disease.经导管主动脉瓣置换术在终末期肝肾功能不全患者中的疗效。
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2
Transcatheter aortic valve replacement (TAVR) as bridge therapy restoring eligibility for liver transplantation in cirrhotic patients.经导管主动脉瓣置换术(TAVR)作为桥接治疗,使肝硬化患者恢复肝移植资格。
Am J Transplant. 2020 Sep;20(9):2567-2570. doi: 10.1111/ajt.15955. Epub 2020 Jul 8.
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Eur Heart J. 2018 Jul 21;39(28):2635-2642. doi: 10.1093/eurheartj/ehy107.
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Transcatheter versus surgical aortic valve replacement in severe, symptomatic aortic stenosis.经导管主动脉瓣置换术与外科主动脉瓣置换术治疗重度症状性主动脉瓣狭窄的比较
J Geriatr Cardiol. 2018 Jan;15(1):76-85. doi: 10.11909/j.issn.1671-5411.2018.01.002.
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Impact of Cirrhosis in Patients Who Underwent Surgical Aortic Valve Replacement.肝硬化对接受外科主动脉瓣置换术患者的影响。
Am J Cardiol. 2017 Aug 15;120(4):648-654. doi: 10.1016/j.amjcard.2017.05.034. Epub 2017 May 30.
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Aortic Stenosis: Diagnosis and Treatment.主动脉瓣狭窄:诊断与治疗
Am Fam Physician. 2016 Mar 1;93(5):371-8.
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J Am Coll Cardiol. 2015 Jan 27;65(3):295-302. doi: 10.1016/j.jacc.2014.10.051.
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Perioperative risk of major non-cardiac surgery in patients with severe aortic stenosis: a reappraisal in contemporary practice.重度主动脉瓣狭窄患者非心脏大手术的围手术期风险:当代实践中的重新评估
Eur Heart J. 2014 Sep 14;35(35):2372-81. doi: 10.1093/eurheartj/ehu044. Epub 2014 Feb 19.