肝移植术后早期死亡的风险因素及预防策略

高天飞; 罗增禧; 高杨; 苏毅; 杨坤; 赵英鹏

doi:10.12449/JCH260932

肝移植术后早期死亡的风险因素及预防策略

DOI: 10.12449/JCH260932

昆明医科大学附属甘美医院/昆明市第一人民医院肝胆外科，昆明 650224

基金项目:

云南省教育厅科学研究基金项目 (2024J0296);

云南省“十四五”期间国家级临床重点专科建设项目 (Yun Wei Ban Yi Fa （2023） No. 10)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：高天飞、罗增禧负责文献检索，撰写文章；苏毅、杨坤负责文献评析，英文校对；高杨、赵英鹏负责修改和审校文章。

详细信息

通信作者:
赵英鹏， 15877991038@163.com （ORCID： 0000-0002-4126-282X）

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出版历程
- 收稿日期: 2026-01-08
- 录用日期: 2026-03-06
- 出版日期: 2026-09-25

Risk factors and preventive strategies for early postoperative mortality following liver transplantation

Department of Hepatobiliary Surgery，The Affiliated Calmette Hospital of Kunming Medical University，The First People’s Hospital of Kunming，Kunming 650224，China

Research funding:

Scientific Research Fund Project of Yunnan Provincial Department of Education (2024J0296);

National-Level Clinical Key Specialty Construction Project in Yunnan Province during the “14th Five-Year Plan” Period (Yun Wei Ban Yi Fa （2023） No. 10)

More Information

Corresponding author: Zhao Yingpeng， 15877991038@163.com （ORCID： 0000-0002-4126-282X）

摘要

摘要: 肝移植是目前终末期肝病最有效的治疗手段之一，其术后早期死亡（通常指术后30 d或90 d内）仍是影响患者预后的关键问题。本文系统综述了肝移植术后早期死亡的研究进展，阐述了早期死亡的定义、发生率及其临床意义，从供体因素、受体术前状态、手术技术、术后并发症及免疫抑制管理等多维度探讨了相关风险因素。重点评述了近年来基于机器学习和大数据的风险预测模型的开发与应用，并对比了不同模型的预测效能。同时，本文总结了现有研究的局限性，并对未来研究方向进行了展望，旨在为临床早期识别高危患者、优化干预策略以降低早期死亡率提供理论依据和参考。
- 肝移植 /
- 预后 /
- 危险因素
Abstract: Liver transplantation is currently one of the most effective treatment methods for end-stage liver disease， and early postoperative mortality （typically defined as within 30 or 90 days after surgery） remains a key issue affecting the prognosis of patients. This article systematically reviews the research advances in early mortality following liver transplantation， elaborates on the definition， incidence rate， and clinical significance of early mortality， and discusses related risk factors from multiple dimensions， including donor factors， the preoperative status of the recipient， surgical techniques， postoperative complications， and immunosuppressive management. Furthermore， it analyzes the development and application of risk prediction models based on machine learning and big data in recent years and compares the predictive efficacy of different models. Meanwhile， this article summarizes the limitations of existing studies and explores future research directions， so as to provide a theoretical basis for the early identification of high-risk patients and the optimization of intervention strategies to reduce early mortality rates in clinical practice.
- Liver Transplantation /
- Prognosis /
- Risk Factors

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注： MELD，终末期肝病模型；MELD-Na，终末期肝病模型-钠；ACLF，慢加急性肝衰竭；GRWR，移植物受者体重比率。

图 1 肝移植术后早期死亡的风险因素

Figure 1. Risk factors for early mortality after liver transplantation

下载: 全尺寸图片幻灯片

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