Early postoperative complications following liver transplantation
Early postoperative complications following liver transplantation
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DOI：
10.1016/j.bpg.2004.07.004
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发表时间：
2004-10-01
影响因子：
3.2
通讯作者：
Kremer, B
中科院分区：
文献类型：
--
作者：
Mueller, AR;Platz, KP;Kremer, B
肝移植是治疗终末期肝病和急性肝功能衰竭的一种非常成功的方法。然而，严重的术后并发症会显著影响患者的生存率。并发症可以是技术性的、医学性的或免疫性的。术后早期并发症的风险与患者的术前状况、供体肝脏的质量、供体和受体程序的质量、初始移植功能以及围手术期麻醉和重症监护管理有关。患者的术前状况可包括消化道出血、急性肾衰竭、需要儿茶酚胺或机械通气以及长期脑病，这些是发展早期术后并发症的最有害风险因素。需要长时间机械通气或移植后需要重新插管可显著增加发生肺炎、败血症和多器官功能障碍的风险。术后早期肠内营养，包括应用益生菌，可以减少感染和其他并发症。
Liver transplantation is a highly successful treatment for patients with end-stage liver disease and acute liver failure. However, serious postoperative complications can significantly compromise patient survival. Complications can be technical, medical, or immunological in nature. The risk of developing early postoperative complications is associated with the patient's preoperative condition, the quality of the donor liver, the quality of the donor and recipient procedure, initial graft function, and perioperative anaesthesiological and intensive care management. The patient's preoperative condition can include gastrointestinal bleeding, acute renal failure, a requirement for cathecholamines or mechanical ventilation, and prolonged encephalopathy for the most detrimental risk factors for developing early postoperative complications. The necessity for prolonged mechanical ventilation or the requirement for reintubation after transplantation can significantly increase the risk of developing pneumonia, sepsis, and multiple organ dysfunction. A decrease in infectious and other complications can be achieved by early postoperative enteral nutition, including the application of probiotics.