肝移植术后并发症与介入治疗

Interventional therapy of complications after liver transplantation: hepatic artery thombosis

肝移植术(LT)后并发症的有效处理很大程度上决定手术的成败。LT后肝动脉血栓形成(HAT)可直接导致移植肝坏死、胆汁瘤与肝功能衰竭。及早发现并明确诊断对预后至关重要,多普勒超声可作为首选的普查方式,CTA、MRA及血管造影可以进一步明确诊断。肝动脉血栓形成后局部溶栓简便易行,与球囊扩张、支架置入技术联合应用通常取得较好的疗效,同时需寻求规范化诊疗方案;血管重建术与加压舱治疗也是有效方法,不得已时,肝脏再移植仍是重要的最后治疗措施。

Resolution of the complications after liver transplantation is one of the important factors related to prognosis. Hepatic artery thombosis （HAT） after liver transplantation can lead directly to transplanted liver undergone necrosis, biloma formation and liver functional exhaustion. The early diagnosis with Color Doppler which should be the first method of choice, CTA, MRA and angiography could lead to exact demonstration, and proper treatment can result in better prognosis. The microinvasive techniques such as local thrombolysis, balloon dilatation and stent placement are safe and effective for treatment of hepatic artery thombosis. The vascular reconstruction and oxygen hyperbaric are effective therapeutic methods. Repeat liver transplantation is still the last important choice for survival.