肝移植时代门静脉高压症的治疗选择

Treatment options for portal hypertension in the era of liver transplantation

肝移植使门静脉高压症的根治成为可能，以肝移植为主的多种治疗手段联合应用的新格局已趋形成。脾切除术、断流术、经颈静脉肝内门体分流术等多种传统治疗手段对肝移植受者转归可产生重要影响。门静脉狭窄、门静脉血栓形成和小体积供肝等因素导致肝移植术后门静脉高压状态及移植肝失功。笔者就此探讨了多种传统治疗方式对受者预后的影响及肝移植术后门静脉高压状态的处理，以期寻求最优治疗策略。

Liver transplantation makes it possible to cure portal hypertension thoroughly. A new pattern of combined application of multiple treatments based on liver transplantation has emerged. Conventional surgical treatments such as splenectomy, devascularization and transjugular intrahepatic portosystemic shunting have important effects on the prognosis of liver transplant recipients. Portal vein stenosis, thrombosis as well as small-for-size liver graft lead to post-transplant portal hypertension and liver dysfunction. The author in this article provides an overview of the effects of various conventional treatments on the prognosis of recipients and the treatment of portal hypertension after liver transplantation, aiming to seek for optimal strategy.