中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝移植治疗慢加急性肝衰竭的临床研究进展

李江 代星 田大治 蒋文涛 沈中阳

引用本文:
Citation:

肝移植治疗慢加急性肝衰竭的临床研究进展

DOI: 10.3969/j.issn.1001-5256.2022.05.045
基金项目: 

国家自然科学基金面上项目 (82072219);

天津市自然科学基金 (17JCQNJC12800)

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:李江负责课题设计,资料分析,撰写论文; 代星、田大治、蒋文涛参与收集数据,修改论文; 沈中阳负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    李江,lijiang_009@163.com

Advances in the clinical research on liver transplantation in treatment of acute-on-chronic liver failure

Research funding: 

Nation Natural Science Foundation of China (General Program) (82072219);

Natural Science Foundation of Tianjin (17JCQNJC12800)

More Information
  • 摘要: 慢加急性肝衰竭是一种慢性肝脏疾病急性加重导致的肝功能急剧恶化的疾病,其通常会伴随多个器官功能衰竭且预后比普通肝硬化差。许多研究认为慢加急性肝衰竭患者若能及时行肝移植手术可以显著提高生存率,然而目前没有可靠的指南指出患者肝移植手术的适应证。本文归纳了近年相关研究并对慢加急性肝衰竭肝移植的指征、时机、预后进行探讨。

     

  • [1] FERNÁNDEZ J, SALIBA F. Liver transplantation in patients with ACLF and multiple organ failure: Time for priority after initial stabilization[J]. J Hepatol, 2018, 69(5): 1004-1006. DOI: 10.1016/j.jhep.2018.09.002.
    [2] WU T, SUNDARAM V. Transplantation for acute-on-chronic liver failure[J]. Clin Liver Dis (Hoboken), 2019, 14(4): 152-155. DOI: 10.1002/cld.852.
    [3] ARTRU F, LOUVET A, RUIZ I, et al. Liver transplantation in the most severely ill cirrhotic patients: A multicenter study in acute-on-chronic liver failure grade 3[J]. J Hepatol, 2017, 67(4): 708-715. DOI: 10.1016/j.jhep.2017.06.009.
    [4] CHOUDHURY A, KUMAR M, SHARMA BC, et al. Systemic inflammatory response syndrome in acute-on-chronic liver failure: Relevance of 'golden window': A prospective study[J]. J Gastroenterol Hepatol, 2017, 32(12): 1989-1997. DOI: 10.1111/jgh.13799.
    [5] BAJAJ JS, MOREAU R, KAMATH PS, et al. Acute-on-chronic liver failure: Getting ready for prime time?[J]. Hepatology, 2018, 68(4): 1621-1632. DOI: 10.1002/hep.30056.
    [6] JALAN R, PAVESI M, SALIBA F, et al. The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure[J]. J Hepatol, 2015, 62(4): 831-840. DOI: 10.1016/j.jhep.2014.11.012.
    [7] WLODZIMIROW KA, ESLAMI S, ABU-HANNA A, et al. A systematic review on prognostic indicators of acute on chronic liver failure and their predictive value for mortality[J]. Liver Int, 2013, 33(1): 40-52. DOI: 10.1111/j.1478-3231.2012.02790.x.
    [8] SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update[J]. Hepatol Int, 2019, 13(4): 353-390. DOI: 10.1007/s12072-019-09946-3.
    [9] MOREAU R, JALAN R, GINES P, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis[J]. Gastroenterology, 2013, 144(7): 1426-1437. e1-e9. DOI: 10.1053/j.gastro.2013.02.042.
    [10] DUSEJA A, SINGH SP. Toward a better definition of acute-on-chronic liver failure[J]. J Clin Exp Hepatol, 2017, 7(3): 262-265. DOI: 10.1016/j.jceh.2017.05.002.
    [11] GUSTOT T, JALAN R. Acute-on-chronic liver failure in patients with alcohol-related liver disease[J]. J Hepatol, 2019, 70(2): 319-327. DOI: 10.1016/j.jhep.2018.12.008.
    [12] SHANG DB, XIANG XG. Advances in the pathogenesis and treatment of acute-on-chronic liver failure[J]. J Clin Hepatol, 2021, 37(4): 765-769. DOI: 10.3969/j.issn.1001-5256.2021.04.005.

    尚大宝, 项晓刚. 慢加急性肝衰竭的发病机制和治疗进展[J]. 临床肝胆病杂志, 2021, 37(4): 765-769. DOI: 10.3969/j.issn.1001-5256.2021.04.005.
    [13] SHALIMAR, KUMAR D, VADIRAJA PK, et al. Acute on chronic liver failure because of acute hepatic insults: Etiologies, course, extrahepatic organ failure and predictors of mortality[J]. J Gastroenterol Hepatol, 2016, 31(4): 856-864. DOI: 10.1111/jgh.13213.
    [14] PAMECHA V, KUMAR S, BHARATHY KG. Liver transplantation in acute on chronic liver failure: Challenges and an algorithm for patient selection and management[J]. Hepatol Int, 2015, 9(4): 534-542. DOI: 10.1007/s12072-015-9646-9.
    [15] KABBANI AR, TERGAST TL, MANNS MP, et al. Treatment strategies for acute-on-chronic liver failure[J]. Med Klin Intensivmed Notfmed, 2021, 116(1): 3-16. DOI: 10.1007/s00063-019-00613-x.
    [16] WONG F, PIANO S, SINGH V, et al. Clinical features and evolution of bacterial infection-related acute-on-chronic liver failure[J]. J Hepatol, 2021, 74(2): 330-339. DOI: 10.1016/j.jhep.2020.07.046.
    [17] LIN KH, LIU JW, CHEN CL, et al. Impacts of pretransplant infections on clinical outcomes of patients with acute-on-chronic liver failure who received living-donor liver transplantation[J]. PLoS One, 2013, 8(9): e72893. DOI: 10.1371/journal.pone.0072893.
    [18] ARTRU F, LOUVET A, RUIZ I, et al. Liver transplantation in the most severely ill cirrhotic patients: A multicenter study in acute-on-chronic liver failure grade 3[J]. J Hepatol, 2017, 67(4): 708-715. DOI: 10.1016/j.jhep.2017.06.009.
    [19] CHOUDHURY A, JINDAL A, MAIWALL R, et al. Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): Comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models[J]. Hepatol Int, 2017, 11(5): 461-471. DOI: 10.1007/s12072-017-9816-z.
    [20] ZHANG L, ZHANG WQ, XIE Y, et al. Clinical observation of liver transplantation in the treatment of 17 cases of acute-on-chronic liver failure induced by discontinuation of nucleoside analogues[J/CD]. Prac J Organ Transplant(Electronic Version), 2021, 9(1): 46-49. DOI: 10.3969/j.issn.2095-5332.2021.01.011.

    张骊, 张炜琪, 谢炎, 等. 肝移植治疗因停用核苷类似物导致的慢加急性肝衰竭17例临床观察[J/CD]. 实用器官移植电子杂志, 2021, 9(1): 46-49. DOI: 10.3969/j.issn.2095-5332.2021.01.011.
    [21] MOON DB, LEE SG, KANG WH, et al. Adult living donor liver transplantation for acute-on-chronic liver failure in high-model for end-stage liver disease score patients[J]. Am J Transplant, 2017, 17(7): 1833-1842. DOI: 10.1111/ajt.14198.
    [22] KNAAK J, MCVEY M, BAZERBACHI F, et al. Liver transplantation in patients with end-stage liver disease requiring intensive care unit admission and intubation[J]. Liver Transpl, 2015, 21(6): 761-767. DOI: 10.1002/lt.24115.
    [23] PETROWSKY H, RANA A, KALDAS FM, et al. Liver transplantation in highest acuity recipients: Identifying factors to avoid futility[J]. Ann Surg, 2014, 259(6): 1186-1194. DOI: 10.1097/SLA.0000000000000265.
    [24] UMGELTER A, LANGE K, KORNBERG A, et al. Orthotopic liver transplantation in critically ill cirrhotic patients with multi-organ failure: A single-center experience[J]. Transplant Proc, 2011, 43(10): 3762-3768. DOI: 10.1016/j.transproceed.2011.08.110.
    [25] DUAN BW, LU SC, WANG ML, et al. Liver transplantation in acute-on-chronic liver failure patients with high model for end-stage liver disease (MELD) scores: A single center experience of 100 consecutive cases[J]. J Surg Res, 2013, 183(2): 936-943. DOI: 10.1016/j.jss.2013.03.008.
    [26] CHOK KSH, CHAN SC, FUNG JY, et al. Survival outcomes of right-lobe living donor liver transplantation for patients with high Model for End-stage Liver Disease scores[J]. Hepatobiliary Pancreat Dis Int, 2013, 12(3): 256-262. DOI: 10.1016/s1499-3872(13)60042-9.
    [27] GUSTOT T, FERNANDEZ J, GARCIA E, et al. Clinical course of acute-on-chronic liver failure syndrome and effects on prognosis[J]. Hepatology, 2015, 62(1): 243-252. DOI: 10.1002/hep.27849.
    [28] PUTIGNANO A, GUSTOT T. New concepts in acute-on-chronic liver failure: Implications for liver transplantation[J]. Liver Transpl, 2017, 23(2): 234-243. DOI: 10.1002/lt.24654.
    [29] LI S, LIU J, CHEN Y. Non-bioartificial liver in liver failure: Clinical application and research advances[J]. J Clin Hepatol, 2019, 35(9): 1909-1915. DOI: 10.3969/j.issn.1001-5256.2019.09.004.

    李爽, 刘静, 陈煜. 非生物型人工肝在肝衰竭中的临床应用及进展[J]. 临床肝胆病杂志, 2019, 35(9): 1909-1915. DOI: 10.3969/j.issn.1001-5256.2019.09.004.
    [30] TANDON R, FROGHI S. Artificial liver support systems[J]. J Gastroenterol Hepatol, 2021, 36(5): 1164-1179. DOI: 10.1111/jgh.15255.
    [31] XU KL, LEI M, YUAN WF, et al. Effect of dual plasma molecular adsorption system in the treatment of hyperbilirubinemia in patients with liver failure[J]. Traum Crit Med, 2020, 8(2): 91-93, 96. DOI: 10.16048/j.issn.2095-5561.2020.02.08.

    许开亮, 雷鸣, 袁维方, 等. 双重血浆分子吸附系统治疗肝衰竭高胆红素患者疗效研究[J]. 创伤与急危重病医学, 2020, 8(2): 91-93, 96. DOI: 10.16048/j.issn.2095-5561.2020.02.08.
    [32] SHANG J, WANG M, WEN Q, et al. A novel prognostic model to predict outcome of artificial liver support system treatment[J]. Sci Rep, 2021, 11(1): 7510. DOI: 10.1038/s41598-021-87055-8.
    [33] SARIN SK, CHOUDHURY A. Management of acute-on-chronic liver failure: An algorithmic approach[J]. Hepatol Int, 2018, 12(5): 402-416. DOI: 10.1007/s12072-018-9887-5.
    [34] BAÑARES R, NEVENS F, LARSEN FS, et al. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial[J]. Hepatology, 2013, 57(3): 1153-1162. DOI: 10.1002/hep.26185.
    [35] GERTH HU, POHLEN M, THÖLKING G, et al. Molecular adsorbent recirculating system can reduce short-term mortality among patients with acute-on-chronic liver failure-a retrospective analysis[J]. Crit Care Med, 2017, 45(10): 1616-1624. DOI: 10.1097/CCM.0000000000002562.
    [36] WAN YM, LI YH, XU ZY, et al. Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus-infected acute-on-chronic liver failure treated by entercavir: A prospective study[J]. J Clin Apher, 2017, 32(6): 453-461. DOI: 10.1002/jca.21535.
    [37] WU B, DU LY, MA YJ, et al. Effects of different combinations of artificial liver support system on efficacy and inflammatory indexes of patients with hepatitis B virus-related acute-on-chronic liver failure in early and middle stages[J/CD]. Chin J Liver Dis (Electronic Version), 2021, 13(1): 32-38. DOI: 10.3969/j.issn.1674-7380.2021.01.006.

    吴蓓, 杜凌遥, 马元吉, 等. 不同组合人工肝支持系统治疗乙型肝炎病毒相关早、中期慢加急性肝衰竭患者的疗效及对炎症指标的影响[J/CD]. 中国肝脏病杂志(电子版), 2021, 13(1): 32-38. DOI: 10.3969/j.issn.1674-7380.2021.01.006.
    [38] LING Q, XU X, WEI Q, et al. Downgrading MELD improves the outcomes after liver transplantation in patients with acute-on-chronic hepatitis B liver failure[J]. PLoS One, 2012, 7(1): e30322. DOI: 10.1371/journal.pone.0030322.
  • 加载中
计量
  • 文章访问数:  543
  • HTML全文浏览量:  116
  • PDF下载量:  41
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-09-14
  • 录用日期:  2021-10-18
  • 出版日期:  2022-05-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回