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[成年肝脏移植受者的治疗态度]

[Therapeutic attitude in adult recipients waiting for liver transplantation].

作者信息

Hadengue A

机构信息

Division de Gastroentérologie, Hôpital Cantonal Universitaire, Geneve, Suisse.

出版信息

Ann Radiol (Paris). 1994;37(5):311-5.

PMID:7993016
Abstract

Any new therapeutic procedure raises the question of its possible interference with a possible liver transplantation. This management must therefore give a change to medical treatments of complications of liver disease without interfering with the possibility of subsequent liver transplantation. The treatment of the complications related to chronic liver disease: gastrointestinal haemorrhage, ascites, ascitic infection are examined from this point of view. The necessity of repeated investigation for hepatocellular carcinoma and the importance of maintaining a correct nutritional status are recalled. The elements of monitoring and treatment which can interfere with the planned transplantation are examined in patients with alcoholic cirrhosis, chronic active viral hepatitis B, sclerosing cholangitis, autoimmune chronic active hepatitis or hepatocellular carcinoma. In fulminant hepatitis, the administration of drugs and any form of clotting factor is prohibited due to the particular risk of altering regular reassessment of the level of consciousness and hepatocellular function. Don't transplant those who are going to recover and don't transplant too late those who are not going to recover.

摘要

任何新的治疗方法都会引发其是否可能干扰潜在肝移植的问题。因此,这种治疗必须在不干扰后续肝移植可能性的前提下,为肝病并发症的药物治疗提供改变。从这一角度出发,对与慢性肝病相关的并发症(胃肠道出血、腹水、腹水感染)的治疗进行了探讨。还回顾了对肝细胞癌进行反复检查的必要性以及维持正确营养状况的重要性。对酒精性肝硬化、慢性活动性乙型病毒性肝炎、硬化性胆管炎、自身免疫性慢性活动性肝炎或肝细胞癌患者中可能干扰计划移植的监测和治疗因素进行了研究。在暴发性肝炎中,由于存在改变意识水平和肝细胞功能定期重新评估的特殊风险,禁止使用药物和任何形式的凝血因子。不要移植那些会康复的患者,也不要对那些不会康复的患者移植过晚。

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