2.Indications of liver transplantation.
Chinese Journal of Hepatology 2004;12(6):371-371
4.Liver transplantation for biliary tract disease.
Acta Academiae Medicinae Sinicae 2005;27(4):423-426
Biliary tract diseases have always been one of the important indications for liver transplantation. These biliary tract diseases include congenital atresia of biliary duct, biliary diseases with tendency of malignant transformation, malignant biliary diseases, primary biliary cirrhosis, and secondary biliary cirrhosis. The right time to consider liver transplantation for the above biliary diseases includes situations when transplantation is the only approach to treat the disease, the only effective approach to treat the disease, or one of the effective approaches to treat the disease. Currently there is still no commonly accepted pre-operative evaluation standard for biliary disease-related liver transplantation. However, it is important to obey the following principles. First, the diagnosis should be confirmed; secondary, the necessity or urgency of the liver transplantation should be clarified; and third, the patient and his/her family should understand the whole procedure of transplantation the risk and advantage of the surgery, and the potential life-long intake of immunosuppressors. This article will briefly review all these relavant issues based on the authors' personal experience and clinical cases.
Biliary Atresia
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surgery
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Biliary Tract Diseases
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surgery
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Humans
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Liver Cirrhosis, Biliary
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surgery
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Liver Transplantation
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Living Donors
7.Adult-to-adult living donor liver transplantation for decompensated end-stage liver diseases.
Xiang-cheng LI ; Xue-hao WANG ; Feng ZHANG ; San-rong XU ; Feng CHENG ; Guo-qiang LI ; Ke WANG ; Xiao-feng QIAN ; Yue-Feng MA
Chinese Journal of Hepatology 2006;14(4):243-246
OBJECTIVETo summarize our clinical experience in adult-to-adult living donor liver transplantation (ALDLT).
METHODSClinical data of 12 patients with ALDLT performed in our center from September 2000 to June 2005 were analyzed, retrospectively.
RESULTSLeft lobe (segments II, III, IV, including the middle hepatic veins) transplantation was performed in 3 patients and right lobe (segments V, VI, VII, VIII, with or without the middle hepatic veins) transplantation was performed in 9 patients. Donors: There were no operative deaths. The median operative time was 6.20+/-1.40 hours and their blood loss ranged from 300 ml to 1200 ml. Postoperative complications included biliary fistula (1 donor) and wound fat liquefaction (1 donor). During a 6-12 months follow-up, no long-term complications were found. Recipients: The operating time ranged from 5 to 11 hours and their blood loss ranged from 800 to 7000 ml. Modified outflow reconstruction, microvascular reconstruction of the hepatic artery and duct-to-duct biliary reconstruction were done during the recipient operations. The median cold ischemia time was 1.90+/-0.50 hours. The median anhepatic phase of recipients was 1.63+/-0.43 hours. Graft/recipient weight ratio (GRWR) was (1.20+/-0.26)%. One recipient presented a postoperative complication of biliary fistula and another recipient died 1 month after the operation from serious infection. The other 11 recipients had long-term survivals.
CONCLUSIONALDLT is an effective treatment for decompensated end-stage liver disease patients and is relatively safe for the donors.
Adult ; Female ; Hepatolenticular Degeneration ; surgery ; Humans ; Liver Cirrhosis ; surgery ; Liver Transplantation ; Living Donors ; Male
10.Current status of liver transplantation for adult patients with acute-on-chronic liver failure.
Ruo Lin WU ; Hong Chuan ZHAO ; Xiao Ping GENG
Chinese Journal of Surgery 2022;60(2):181-187
Acute-on-chronic liver failure(ACLF) is the most severe form of acute decompensation that develops in patients with chronic liver disease or liver cirrhosis,and is always accompanied by one or more extrahepatic organ failure, and has an extremely poor short-term prognosis. The causes triggering ACLF are complex and diverse,and the clinical stage and the type and the definition of organ failure differ greatly from one another. Therefore, a universally accepted diagnostic criteria for ACLF is not to be defined, and the epidemiological data and patient outcomes on ACLF are not easy to predict and compare among different regions. Accumulating evidence has shown that liver transplantation(LT) plays a significant role in the surgical treatment of patients with ACLF,but its clinical value is still controversial. The specific management and treatment strategy after the admission of patients with ACLF has not yet formed a unified and standardized process or opinions, which includes the monitoring in the ICU,the support and maintenance of organ functions, the selection of the surgical indication and the timing for LT and so on. Moreover, there still exists many controversies concerning, for example, whether patients with ACLF should receive greater priority for organ allocation compared to other potential candidates on the waiting list. Besides, more prospective controlled studies are urgently needed to investigate the role of the artificial liver support system in the bridging therapy to LT. The aim of this article is to review the indication selection of patients with ACLF suitable for LT,the survival outcomes and prognostic factors after LT, the selection of timing, the organ allocation policy and the bridging therapy to LT, which intends to provide new direction for designing the future clinical studies on LT in patients with ACLF.
Acute-On-Chronic Liver Failure/surgery*
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Adult
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Humans
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Liver Cirrhosis
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Liver Transplantation
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Prognosis
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Prospective Studies
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Waiting Lists
Result Analysis
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