PDF(Pubmed)
Abstract：
BACKGROUND: Liver transplantation (LT) is a well-established method applied for the treatment of various liver diseases, including primary and secondary malignancies, as well as acute liver failure triggered by different mechanisms. In turn, liver failure (PHLF) is the most severe complication observed after liver resection (LR). PHLF is an extremely rare indication for LT. The aim of the present study was to assess the results of LT in patients with PHLF.
METHODS: Relevant cases were extracted from the prospectively collected database of all LTs performed in our center. All clinical variables, details of the perioperative course of each patient and long-term follow-up data were thoroughly assessed.
RESULTS: Between January 2000 and August 2023, 2703 LTs were carried out. Among them, six patients underwent LT for PHLF, which accounted for 0.2% of all patients. The median age of the patients was 38 years (range 24-66 years). All patients underwent major liver resection before listing for LT. The 90-day mortality after LT was 66.7% (4 out of 6 patients), and all patients experienced complications in the posttransplant course. One patient required early retransplantation due to primary non-function (PNF). The last two transplanted patients are alive at 7 years and 12 months after LT, respectively.
CONCLUSIONS: In an unselected population of patients with PHLF, LT is a very morbid procedure associated with high mortality but should be considered the only life-saving option in this group.
METHODS: Relevant cases were extracted from the prospectively collected database of all LTs performed in our center. All clinical variables, details of the perioperative course of each patient and long-term follow-up data were thoroughly assessed.
RESULTS: Between January 2000 and August 2023, 2703 LTs were carried out. Among them, six patients underwent LT for PHLF, which accounted for 0.2% of all patients. The median age of the patients was 38 years (range 24-66 years). All patients underwent major liver resection before listing for LT. The 90-day mortality after LT was 66.7% (4 out of 6 patients), and all patients experienced complications in the posttransplant course. One patient required early retransplantation due to primary non-function (PNF). The last two transplanted patients are alive at 7 years and 12 months after LT, respectively.
CONCLUSIONS: In an unselected population of patients with PHLF, LT is a very morbid procedure associated with high mortality but should be considered the only life-saving option in this group.
摘要：
背景：肝移植（LT）是一种公认的用于治疗各种肝病的方法，包括原发性和继发性恶性肿瘤，以及由不同机制引发的急性肝功能衰竭。反过来,肝衰竭（PHLF）是肝切除术（LR）后观察到的最严重的并发症。PHLF是LT的极其罕见的适应症。本研究的目的是评估PHLF患者的LT结果。
方法：从前瞻性收集的在我们中心进行的所有LTs的数据库中提取相关病例。所有临床变量，我们对每位患者的围手术期细节和长期随访数据进行了全面评估.
结果：在2000年1月至2023年8月之间，进行了2703LTs。其中,六名患者接受了PHLFLT，占所有患者的0.2%。患者的中位年龄为38岁（范围24-66岁）。所有患者在上市前进行了肝脏大切除术。LT术后90天死亡率为66.7%（6例患者中有4例），所有患者在移植后的过程中都出现了并发症。一名患者由于原发性无功能（PNF）而需要早期再移植。最后两名移植患者在LT术后7年12个月存活，分别。
结论：在未选择的PHLF患者人群中，LT是一种与高死亡率相关的非常病态的手术，但应该被认为是该组中唯一的挽救生命的选择。
方法：从前瞻性收集的在我们中心进行的所有LTs的数据库中提取相关病例。所有临床变量，我们对每位患者的围手术期细节和长期随访数据进行了全面评估.
结果：在2000年1月至2023年8月之间，进行了2703LTs。其中,六名患者接受了PHLFLT，占所有患者的0.2%。患者的中位年龄为38岁（范围24-66岁）。所有患者在上市前进行了肝脏大切除术。LT术后90天死亡率为66.7%（6例患者中有4例），所有患者在移植后的过程中都出现了并发症。一名患者由于原发性无功能（PNF）而需要早期再移植。最后两名移植患者在LT术后7年12个月存活，分别。
结论：在未选择的PHLF患者人群中，LT是一种与高死亡率相关的非常病态的手术，但应该被认为是该组中唯一的挽救生命的选择。
