非生物人工肝在重型肝炎患者过渡肝移植中的应用价值

Application value of non-bioartificial liver for patients awaiting liver transplantation in severe hepatitis patients

目的 评价非生物人工肝对重型病毒性肝炎 (重型肝炎 )患者等待肝移植的过渡支持作用与价值。方法 采用血浆置换和血浆吸附两种非生物人工肝支持疗法 ,对 8例拟定肝移植的中晚期重型肝炎患者进行人工肝过渡支持。结果 8例重型肝炎患者经人工肝支持 ,4例肝衰竭得到较好的控制 ,4～ 13d后成功等到供肝。另 4例肝衰竭控制不明显 ,病情呈进行性加重 ,在待肝过程中 (人工肝支持后 3～ 8d)死亡。结论 非生物人工肝对等待肝移植的重型肝炎患者有一定的过渡支持作用 ,能否最终成功过渡与患者肝衰竭程度、并发症及待肝时间密切相关。

Objective To investigate the bridging role of non bioartificial liver for patients with severe viral hepatitis (severe hepatitis) awaiting liver transplantation. Methods 8 candidates for liver transplantation with metaphase and advanced stage liver failure received the support of non bioartificial liver. Plasmapheresis and plasma absoption,the two typical non bioartificial liver supports were employed in the treatment of severe hepatitis patients. Results Among the 8 patients, 4 patients' liver clinical status were controlled by the artificial liver support system temporarily and were bridged to orthotopic liver transplantation successfully after 4 to 13 days. Treatment failed in another four patients whose condition deteriorated progressively and died while awaiting for transplantation. Conclusions Non bioartificial liver have some supportive effect for patients with severe viral hepatitis to await liver transplantation. The treatment effects was related to the degree of liver failure, complications and the awaiting time of liver transplantation.