肝昏迷患者经人工肝治疗后成功行跨血型肝移植1例报告

孙爽; 刘金泉; 冯帅; 王淑贤; 徐祥美; 戴德淑; 王建红; 蔡金贞; 许传屾

doi:10.12449/JCH240423

肝昏迷患者经人工肝治疗后成功行跨血型肝移植1例报告

DOI: 10.12449/JCH240423

青岛大学附属医院器官移植中心，山东青岛 266000

基金项目:

山东省自然科学基金面上项目 (ZR2023MH240);

北京肝胆相照公益基金会“2023年度人工肝专项基金” (iGandanF-1082023-RGG037);

青岛大学附属医院“临床医学+X”科研项目 (QYFY+X202101060)

伦理学声明：本例报告已获得患者知情同意。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：孙爽负责课题设计，资料分析，撰写论文；刘金泉、冯帅、王淑贤、徐祥美、戴德淑负责课题设计；王建红、蔡金贞负责拟定写作思路；许传屾负责指导撰写文章并最后定稿。

详细信息

通信作者:
许传屾， xcs774279@163.com （ORCID： 0009-0004-0770-6409）

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出版历程
- 收稿日期: 2023-07-19
- 录用日期: 2023-09-18
- 出版日期: 2024-04-25

Successful trans-blood liver transplantation after artificial liver support therapy in a patient with hepatic coma： A case report

Organ Transplantation Center，The Affiliated Hospital of Qingdao University，Qingdao，Shandong 266000，China

Research funding:

General Project of Shandong Natural Science Foundation (ZR2023MH240);

The “2023 Artificial Liver Special Fund” of the Beijing Hepatobiliary Mutual Welfare Foundation (iGandanF-1082023-RGG037);

The “Clinical Medicine+X” Research Project of Qingdao University Affiliated Hospital (QYFY+X202101060)

More Information

Corresponding author: XU Chuanshen， xcs774279@163.com （ORCID： 0009-0004-0770-6409）

摘要

摘要: 本文报告1例经过人工肝支持治疗并成功过渡到肝移植的肝昏迷患者，经过积极治疗后患者后期恢复较好。并且对肝移植手术的时机进行了讨论。
- 肝移植 /
- 肝功能衰竭 /
- 肝，人工
Abstract: This article reports a patient with hepatic coma who underwent artificial liver support therapy and liver transplantation successfully， and the patient recovered well in the later stage after active treatment. This article also discusses the timing of liver transplantation.
- Liver Transplantation /
- Liver Failure /
- Liver， Artificial

HTML全文

图 1 经过人工肝治疗后患者血氨、总胆红素、转氨酶的变化情况

注：红色箭头提示行非生物型人工肝的时机。

Figure 1. Changes in blood ammonia， total bilirubin， and transaminase in patients after artificial liver treatment

下载: 全尺寸图片幻灯片

图 2 手术切下的病肝

Figure 2. Photos of diseased liver

下载: 全尺寸图片幻灯片

图 3 移植后的新肝

Figure 3. Photos of new liver

下载: 全尺寸图片幻灯片

参考文献(12)

[1]	Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
[2]	WU CB, ZHOU MX, MENG Y, et al. Application and research progress of non-bioartificial liver[J]. Biomed Eng Clin Med, 2021, 25( 5): 634- 638. DOI: 10.13339/j.cnki.sglc.20210820.009. 吴春波, 周明雪, 孟彦, 等. 非生物型人工肝的应用及研究进展[J]. 生物医学工程与临床, 2021, 25( 5): 634- 638. DOI: 10.13339/j.cnki.sglc.20210820.009.
[3]	CHEN MJ, LI X, TANG SH. Advances in multi-dimensional assessment of liver function in the prognosis of patients with liver failure[J]. Clin J Med Offic, 2023, 51( 9): 901- 903, 907. DOI: 10.16680/j.1671-3826.2023.09.05. 陈美娟, 李雪, 汤善宏. 多维度评估肝功能在肝衰竭患者预后中研究进展[J]. 临床军医杂志, 2023, 51( 9): 901- 903, 907. DOI: 10.16680/j.1671-3826.2023.09.05.
[4]	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.
[5]	KAMATH PS, WIESNER RH, MALINCHOC M, et al. A model to predict survival in patients with end-stage liver disease[J]. Hepatology, 2001, 33( 2): 464- 470. DOI: 10.1053/jhep.2001.22172.
[6]	MARTIN P, DIMARTINI A, FENG S, et al. Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation[J]. Hepatology, 2014, 59( 3): 1144- 1165. DOI: 10.1002/hep.26972.
[7]	European Association for the Study of the Liver. EASL clinical practice guidelines: Liver transplantation[J]. J Hepatol, 2016, 64( 2): 433- 485. DOI: 10.1016/j.jhep.2015.10.006.
[8]	Hepatology Branch of the Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006. 中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
[9]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of hepatic encephalopathy in cirrhosis[J]. J Clin Hepatol, 2018, 34( 10): 2076- 2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007. 中华医学会肝病学分会. 肝硬化肝性脑病诊疗指南[J]. 临床肝胆病杂志, 2018, 34( 10): 2076- 2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007.
[10]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of ascites and complications in cirrhosis[J]. J Clin Hepatol, 2017, 33( 10): 1847- 1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003. 中华医学会肝病学分会. 肝硬化腹水及相关并发症的诊疗指南[J]. 临床肝胆病杂志, 2017, 33( 10): 1847- 1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003.
[11]	European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69( 2): 406- 460. DOI: 10.1016/j.jhep.2018.03.024.
[12]	BOYER TD, SANYAL AJ, GARCIA-TSAO G, et al. Impact of liver transplantation on the survival of patients treated for hepatorenal syndrome type 1[J]. Liver Transpl, 2011, 17( 11): 1328- 1332. DOI: 10.1002/lt.22395.