暴发性肝功能衰竭的急诊肝脏移植治疗

Emergency orthotopic liver transplantation for the treatment of fulminant hepatic failure

目的探讨急诊肝脏移植对暴发性肝功能衰竭(FHF)的疗效。方法回顾性分析笔者所在中心2005-03～2006-03收治7例暴发性肝功能衰竭患者的临床资料及其治疗效果。结果行急诊肝脏移植治疗6例,术后1例并发原发性移植肝无功能,5例患者于48h内苏醒。1例男性患者术后并发急性肾功能衰竭,1例患者术后发生排斥反应,经治疗后逆转。1例男性患者并发口腔严重溃疡。2例并发急性呼吸窘迫综合征(ARDS),行气管切开。目前生存4例均生活状况良好,已重返工作岗位。结论急诊肝脏移植是治疗暴发性肝功能衰竭的有效方法,为患者等待供体赢得宝贵的时间是提高移植成功率的关键。

Objective To evaluate the efficacy of emergency orthotopic liver transplantation in treating patients with fulminant hepatic failure （FHF）. Method The clinical data of 7 patients from March of 2005yr to June of 2005yr who underwent emergency orthotopic liver transplantation （EOUF）were analyzed retrospectively. Results One patient was complicated with prilnary non-function of the transplanted liver after liver transplantation;Five patients completed regained consciousness within 48 hours after operation; One patient complicated with acute renal failure;One patient complicated with acute liver cell rejection postoperatively and reversed after treatment;One male patient complicated with serious stomatocace;Two patients complicated with acute respiratory distress syndrome（ARDS）,underwent tracheotomy. Now 4 of the 7 patients survive with excellent quality of life,and have returned to work. Conclusion Emergency orthotopic liver tranplantation is an effective means to treat fulmilnant hepatic failure. It is essential for improving the successful rate of emergency orthotopic liver transplantation to win valuable time for gaining the donor through coming with appropriate preoperative management.