Sokal E M
Department of Paediatrics, Cliniques St Luc, Université Catholique de Louvain, Bruxelles, Belgium.
Eur J Pediatr. 1995 Mar;154(3):171-5. doi: 10.1007/BF01954265.
Orthotopic liver transplantation is now routinely performed as a cure of numerous untreatable paediatric liver diseases. Evaluation of post-transplant quality of life is subjective and very difficult. It has to take into account the pre-transplant quality of life and the emotional stress to the family. Transplantation saves life in 65%-90% of the patients. Several diseases may, however, recur after transplantation, such as hepatitis B, C or NANB, or tumours. Some metabolic diseases may also progress in other organs. Extra-hepatic manifestations or sequelae may persist after transplantation. Complications of transplantation include renal function impairment, hypertension, viral and opportunistic diseases. Of particular concern is the post-transplant lymphoproliferative syndrome. Liver transplantation is able to restore growth. Children are less frequently admitted to hospital after transplantation, take fewer medications, return to school, are less dependent and interact more normally with their peers. Quality of life may not reach perfection, and depends also on the way our society accepts these imperfections.
原位肝移植如今已成为治疗众多无法治愈的儿科肝脏疾病的常规手段。对移植后生活质量的评估具有主观性且极具难度。这必须要考虑到移植前的生活质量以及家庭所承受的情感压力。移植手术能挽救65%至90%患者的生命。然而，一些疾病在移植后可能会复发，比如乙型、丙型或非甲非乙型肝炎，或者肿瘤。一些代谢性疾病也可能在其他器官中进展。移植后肝外表现或后遗症可能会持续存在。移植的并发症包括肾功能损害、高血压、病毒性疾病和机会性感染。尤其值得关注的是移植后淋巴组织增生综合征。肝移植能够恢复生长发育。儿童在移植后住院频率降低，用药减少，重返校园，依赖性降低，与同龄人互动也更为正常。生活质量或许无法达到完美状态，这也取决于我们社会接受这些不完美的方式。
