成人慢加急性肝衰竭肝移植围手术期管理专家共识

Expert consensus on perioperative management of liver transplantation in adults with acute-on-chronic liver failure Transplantation

慢加急性肝衰竭(ACLF)是在慢性肝病的基础上发生的急性肝衰竭合并肝外器官衰竭综合征,肝移植是目前治疗ACLF唯一的有效手段。ACLF最佳手术时机的选择、围手术期感染防控、营养及器官功能的维护等难题仍存在探讨空间。中国医师协会器官移植医师分会移植免疫学专业委员会和中国研究型医院学会加速康复外科委员会肝移植加速康复学组组织了相关专家从手术时机、器官保护、营养支持、感染防控、康复锻炼以及内环境调节等方面对ACLF肝移植围手术期管理进行了讨论并制定专家共识,以供临床医师参考。

Acute-on-chronic liver failure(ACLF)is a syndrome of acute liver failure complicated by other organ failure on the basis of chronic liver disease.Liver transplantation is the only effective treatment for ACLF.There is still discussion space on the optimal operation timing of ACLF,how to reduce postoperative infection rate,improvement of nutrition and body function.Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association and Enhanced Recovery of Liver Transplantation Group of Enhanced Recovery after Surgery Committee of Chinese Research Hospital Society organized relevant experts to discuss the perioperative management of ACLF liver transplantation from the operation timing,organ protection,nutritional support,infection prevention and control,rehabilitation exercise and regulation of the internal environment,etc.And the expert consensus was developed for the reference of clinicians.