SPECIFIC PROBLEMS AND STRATEGIES OF LIVER TRANSPLANTATION IN CHINA
- VernacularTitle:我国肝脏移植的特殊问题与对策
- Author:
Bingyi SHI
- Publication Type:Journal Article
- Keywords:
liver transplantation;
hepatitis B;
carcinoma, hepatocellular;
postoperative complications;
liver, artificial
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
The development status and specific problems of liver transplantation in China were analyzed, and the strategies to resolve these problems were discussed in this study. "Hepatitis B related diseases", including cirrhosis and hepatic cancer, were the main indications for liver transplantation in China. Recurrence of hepatitis B and hepatic cancer was found to significantly affect the long term survival of the recipients of liver transplantation. Severe hepatitis and fulminating liver failure were the main causes of death in the perioperative periods of liver transplantation. Nonanastomotic biliary stricture (NABS) and acute rejection often occurred. Lamivudine and anti-Hepatitis B immunoglobulin(HBIg) could effectively protect the recipients from hepatitis B recurrence. The indication of liver transplantation for the patients with the hepatic cancer should be observed strictively, and measures should be taken before and during the operation to prevent the recurrence of the cancer. In the patients with severe hepatitis and fulminating liver failure, therapy to support the liver function should be emphasized and the artificial liver support system (ALSS) should be administered. The prognosis of NABS was found to be poor, and biliary duct dilatation with balloon catheter might be an effective treatment for NABS, but retransplantation was necessary for some of the patients. The rate of biopsy of the liver graft, the quality of the biopsy and the level of pathological diagnosis should be greatly enhanced.
