成人肝移植术后血管并发症的诊治

Diagnosis and treatment of vascular complications after liver transplantation in adults

  • 摘要: 肝移植作为终末期肝病和肝脏原发恶性肿瘤的有效治疗方法已在世界范围内广泛开展,并逐渐取得人民群众的普遍认可。随着器官移植技术的发展,成人肝移植术后血管并发症已很少发生,但术后血栓形成、吻合口狭窄等血管并发症在活体肝移植、劈离式肝移植受者中仍较为常见,治疗不当可导致移植物丢失和受者死亡。笔者从事肝移植工作多年,见证了肝移植术后血管并发症诊治技术的不断发展,本文从肝动脉并发症、门静脉并发症、下腔静脉和肝静脉并发症的病因、临床表现、诊断及治疗方法,评述不同血管并发症的诊治现状和发展趋势,为进一步提高移植物和受者生存率,促进临床肝移植的发展提供参考。

     

    Abstract: As an efficacious treatment for end-stage liver diseases and primary malignant liver tumors, liver transplantation has been widely applied worldwide, and gradually receives widespread recognition from patients. With the development of organ transplant technique, vascular complications have rarely occurred after adult liver transplantation. However, vascular complications, such as postoperative thrombosis and anastomotic stenosis, are still common in the recipients undergoing living donor liver transplantation and split liver transplantation. Inappropriate treatment may lead to the loss of grafts and death of recipients. The authors have been engaged in liver transplantation for many years, witnessing persistent development of diagnostic and therapeutic technologies for vascular complications after liver transplantation. In this article, current status and development trend of diagnosis and treatment of different vascular complications were illustrated from the etiology, clinical manifestations, diagnosis and treatment of hepatic artery complications, portal vein complications, inferior vena cava and hepatic vein complications, aiming to further improve the survival rate of grafts and recipients and provide reference for promoting the development of clinical liver transplantation.

     

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