自体肝移植患者术前评估研究进展

摘要

Auto liver transplantation (ALT) is a treatment option for patients with liver space-occupying lesion that could not be removed by conventional surgery and severe liver trauma,which also helps alleviate the shortage of donor liver.But many problems like the preoperative assessment,the tolerance of patients to surgery and anesthesia,delayed postoperative recovery of the liver function,primary non-function,liver failure and hepatic encephalopathy and even death still need to be addressed.Thus,it is particularly important to evaluate the operative indication,completely and accurately assess the preoperative liver function and liver function reserve,and reduce the perioperative mortality and complication in order to improve the prognosis of ALT.Combined with literalure and the experience in our center,this paper summarized the research advance of preoperative assessment in patients with ALT.%自体肝移植(ALT)为不能常规手术切除的肝脏占位性病灶或严重肝脏外伤患者提供手术治愈的可能,也为缓解目前供肝短缺开辟了新的途径.但外科医师仍需面临术前评估、患者对手术和麻醉的耐受、术后肝功能延迟恢复、原发性无功能、肝功能衰竭、肝性脑病甚至死亡等诸多不良预后问题.因此,完善手术适应证、术前准确评估肝功能及肝脏储备能力对于减少围手术期病死率和并发症、改善肝切除自体移植预后尤为重要.结合相关文献及本中心经验,本文系统总结了ALT患者术前评估方面的研究进展.