Becker F, Trebicka J, Houben P, Pascher A
Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
Medizinische Klinik B, Gastroenterologie, Hepatologie, Endokrinologie, Klinische Infektiologie, Universitätsklinikum Münster, Münster, Deutschland, Albert-Schweitzer-Campus 1, 48149.
Chirurgie (Heidelb). 2024 Feb;95(2):115-121. doi: 10.1007/s00104-023-01992-w. Epub 2023 Nov 17.
A review and discussion of the current literature on liver transplantation for acute-on-chronic liver failure (ACLF) was performed. The ACLF represents an acute deterioration of liver function with pre-existing liver disease and is associated with increasing multiorgan failure, depending on the stage. The 28-day mortality ranges to well over 70% in stage 3 and requires rapid intensive medical treatment involving an interdisciplinary team experienced in transplantation medicine. Under optimized conditions, liver transplantation provides long-term survival rates comparable to other indications. Achieving this requires a differentiated donor selection, choosing the appropriate time for transplantation in the context of a dynamic disease course and the use of appropriate surgical techniques.
对当前关于急性慢性肝衰竭（ACLF）肝移植的文献进行了综述和讨论。ACLF表现为已有肝病基础上的肝功能急性恶化，并根据阶段不同与多器官功能衰竭的增加相关。在3期，28天死亡率高达70%以上，需要由移植医学经验丰富的跨学科团队进行快速强化治疗。在优化条件下，肝移植可提供与其他适应症相当的长期生存率。要实现这一点，需要进行差异化的供体选择，在动态病程中选择合适的移植时间，并采用适当的手术技术。
