急性肝衰竭肝移植围手术期治疗的研究进展

Perioperative management in liver transplantation for acute liver failure

急性肝衰竭(acute liver failure,ALF)起病急、病情进展快,传统的内科治疗及单纯的非生物人工肝治疗难以逆转ALF预后,肝移植是目前临床唯一有效治疗手段,但由于供肝短缺患者需等待时间较长,以及移植后复杂的术后并发症、免疫抑制剂和抗生素的大量使用等问题的存在,使得ALF患者在肝移植围手术期面临着各种各样的难题,并直接关系到肝移植手术成功率以及术后并发症的发生率、病死率.本文从术前如何延长患者生命以及术后并发症处理新进展两方面,探讨ALF肝移植围手术期难点及其防治措施.

Acute liver failure occurs abruptly with rapid progression. Traditional medical treatment and simple non-bioartificial liver support system cannot reverse the prognosis of acute liver fail- ure （ALF）, and liver transplantation is the only effective treatment. However, donor liver short- age, the need of a life-long immunosuppressive therapy as well as complex postoperative com- plications make ALF patients facing a variety of challenges in the perioperative period of liver transplantation, which are directly related to the success rate of surgery and the mortality. This article aims to discuss perioperative difficulties and preventive measures in liver transplantation for ALF by exploring how to extend the lives of patients before liver transplantation and how to deal with postoperative complications.