Pedersen S S, Bro S, Schlichting P, Vilstrup H, Kirkegaard P, Kondrup J
Medicinsk afdeling A (hepatologisk afsnit), Rigshospitalet, København.
Ugeskr Laeger. 1993 Mar 8;155(10):691-4.
Emergency liver transplantation is the treatment of choice in acute liver failure without signs of spontaneous regeneration. However, many patients rapidly contract irreversible neurological complications before transplantation can be performed. We used high-volume plasmapheresis to increase the time span to obtain a donor liver. Four patients with acute liver failure of unknown cause and a galactose elimination capacity indicative of a virtually extinct liver function were assigned maximum priority for liver transplantation. Plasmapheresis were performed daily until transplantation. Each time 8-10 liters of patient plasma were replaced with an equal volume of fresh donor plasma. There were no major complications. None of the patients developed irreversible neurological complications for 48-144 h at which time liver transplantation was performed. High volume plasmapheresis increases the time to obtain a donor liver for emergency liver transplantation and optimizes the condition for the surgical procedure.
紧急肝移植是急性肝衰竭且无自发再生迹象时的首选治疗方法。然而，许多患者在能够进行移植之前迅速出现不可逆的神经并发症。我们采用大容量血浆置换来延长获取供体肝脏的时间跨度。四名病因不明且半乳糖清除能力表明肝功能几乎丧失的急性肝衰竭患者被赋予肝移植的最高优先级。每天进行血浆置换直至移植。每次用等量的新鲜供体血浆替换8 - 10升患者血浆。未出现重大并发症。所有患者在48 - 144小时内均未出现不可逆的神经并发症，随后进行了肝移植。大容量血浆置换增加了紧急肝移植获取供体肝脏的时间，并优化了手术条件。
