Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.Th...Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.There is still room for discussion on the optimal surgery timing for ACLF,perioperative infection prevention and control,and maintenance of nutrition and organ function.The Transplantation Immu-nology 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 Association invited relevant experts to discuss the perioperative management of ACLF liver transplantation in areas including surgery timing,organ protection,nutritional support,infection prevention and control,rehabilitation exercises,regulation of the internal environment,etc.An expert consensus was developed as reference for clinicians.展开更多
Acute-on-chronic liver failure(ACLF)can be cured by liver transplantation;however,perioperative complications still affect posttransplant outcomes.In recent years,early rehabilitation for critical illness,liver diseas...Acute-on-chronic liver failure(ACLF)can be cured by liver transplantation;however,perioperative complications still affect posttransplant outcomes.In recent years,early rehabilitation for critical illness,liver disease,and surgery have significantly improved organ reserve function,surgery tolerance,and postoperative quality of life.They could also be applied in the perioperative period of liver transplantation in patients with ACLF.Therefore,the Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association,the Organ Transplant Committee of China Association Rehabilitation Medicine,and the Guangdong Medical Doctor Association of Organ Transplantation conducted a comprehensive review of rehabilitation in end-stage liver disease,critical illness and surgical patients by summarizing current evidence and best clinical practices and proposed a practice consensus on evaluation of cardiopulmonary and physical function,rehabilitation or physiotherapies,as well as the safety concerns in perioperative liver transplant recipients.It will be a valuable resource for hepatologists,transplant surgeons,and intensivists as they care for ACLF patients during transplantation.展开更多
基金This work was supported by National 13th Five-Year Science and Technology Plan Major Projects of China(2017ZX10203205-006-001)National Key Research and Development Program of China(2017YFA0104304)+3 种基金National Natural Science Foundation of China(81770648,81972286)Natural Science Foundation of Guangdong Province,China(2015A030312013,2018A0303130305)Science and Technology Program of Guangdong Province,China(2017B020209004,20169013,2020B1212060019)Guangzhou Science and Technology Project,China(201400000001-3).
文摘Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.There is still room for discussion on the optimal surgery timing for ACLF,perioperative infection prevention and control,and maintenance of nutrition and organ function.The Transplantation Immu-nology 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 Association invited relevant experts to discuss the perioperative management of ACLF liver transplantation in areas including surgery timing,organ protection,nutritional support,infection prevention and control,rehabilitation exercises,regulation of the internal environment,etc.An expert consensus was developed as reference for clinicians.
基金This work was supported by the Guangdong Provincial Natural Science Foundation(2019A1515011106,2021A1515012382,2022A1515011919)National Natural Science Foundation of China(81972286,81770648,81972151)+2 种基金Guangdong Provincial Transplantation Medicine Engineering Laboratory(A04097)Guangdong Provincial Key Research and Development Project(2019B020236003)The Third Affiliated Hospital of Sun Yat-sen University Five Five-Year Engineering Projects-National Bioengineering Research Institute Development Platform(WW201905(2021)).
文摘Acute-on-chronic liver failure(ACLF)can be cured by liver transplantation;however,perioperative complications still affect posttransplant outcomes.In recent years,early rehabilitation for critical illness,liver disease,and surgery have significantly improved organ reserve function,surgery tolerance,and postoperative quality of life.They could also be applied in the perioperative period of liver transplantation in patients with ACLF.Therefore,the Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association,the Organ Transplant Committee of China Association Rehabilitation Medicine,and the Guangdong Medical Doctor Association of Organ Transplantation conducted a comprehensive review of rehabilitation in end-stage liver disease,critical illness and surgical patients by summarizing current evidence and best clinical practices and proposed a practice consensus on evaluation of cardiopulmonary and physical function,rehabilitation or physiotherapies,as well as the safety concerns in perioperative liver transplant recipients.It will be a valuable resource for hepatologists,transplant surgeons,and intensivists as they care for ACLF patients during transplantation.
