肝移植受者术前心脏疾病风险评估的现状及展望

Current status and prospect of preoperative assessment of heart disease risk in liver transplant recipients

  • 摘要: 随着肝移植疾病谱和器官分配体系等因素的改变,越来越多伴有心血管合并症的患者进入移植等待名单。手术应激、严重感染、免疫抑制药物不良反应等亦会导致术后心脏并发症发生风险显著增加,影响受者短期及长期生存。因此,术前对受者心脏结构及功能进行全面评估,对改善肝移植预后尤其重要。本文就肝移植围手术期心脏疾病风险增加的主要原因、肝移植受者心脏疾病风险评估的时机和方法进行综述,介绍当前肝移植术前常见心脏疾病的评估手段,以期为进一步降低肝移植术后心脏并发症发生率、提高移植物和受者存活率、改善临床预后结果提供参考。

     

    Abstract: With the changes of the disease spectrum of liver transplantation and organ allocation system, more and more patients complicated with cardiovascular complications have entered the waiting list for liver transplantation. However, surgical stress, severe infection and adverse reactions of immunosuppressive drugs will significantly increase the risk of postoperative cardiac complications and affect the short-and long-term survival of the recipients. Therefore, comprehensive evaluation of cardiac structure and function of the recipients before liver transplantation is of significance for improving clinical prognosis of the recipients. In this article, the main causes for the increased risk of heart disease during the perioperative period of liver transplantation, the time and methods of heart disease risk assessment for liver transplant recipients were reviewed, and existing assessment approaches for common heart diseases before liver transplantation were illustrated, aiming to provide reference for further reducing the incidence of heart complications after liver transplantation, improving the survival rates of grafts and recipients and enhancing clinical prognosis.

     

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