Lv Haijin, Zheng Haiqing, Liu Jianrong, Cai Qing, Ren Yuji, Yi Huimin, Yang Yang, Hu Xiquan, Chen Guihua
Surgical Intensive Care Unit, Intensive Care Unit of Organ Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Liver Res. 2022 Aug 18;6(3):121-129. doi: 10.1016/j.livres.2022.08.002. eCollection 2022 Sep.
Acute-on-chronic liver failure (ACLF) can be cured by liver transplantation; however, perioperative complications still affect posttransplant outcomes. In recent years, early rehabilitation for critical illness, liver disease, and surgery have significantly improved organ reserve function, surgery tolerance, and postoperative quality of life. They could also be applied in the perioperative period of liver transplantation in patients with ACLF. Therefore, the Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association, the Organ Transplant Committee of China Association Rehabilitation Medicine, and the Guangdong Medical Doctor Association of Organ Transplantation conducted a comprehensive review of rehabilitation in end-stage liver disease, critical illness and surgical patients by summarizing current evidence and best clinical practices and proposed a practice consensus on evaluation of cardiopulmonary and physical function, rehabilitation or physiotherapies, as well as the safety concerns in perioperative liver transplant recipients. It will be a valuable resource for hepatologists, transplant surgeons, and intensivists as they care for ACLF patients during transplantation.
急性慢性肝衰竭(ACLF)可通过肝移植治愈;然而,围手术期并发症仍会影响移植后的结局。近年来,针对危重症、肝脏疾病及手术的早期康复显著改善了器官储备功能、手术耐受性及术后生活质量。这些康复措施也可应用于ACLF患者肝移植的围手术期。因此,中华医学会器官移植分会移植免疫委员会、中国康复医学会器官移植委员会及广东省医师协会器官移植分会通过总结现有证据及最佳临床实践,对终末期肝病、危重症及手术患者的康复进行了全面综述,并就心肺和身体功能评估、康复或物理治疗以及肝移植围手术期受者的安全问题提出了实践共识。这将为肝病学家、移植外科医生及重症监护医生在肝移植期间护理ACLF患者提供宝贵资源。