网站大量收购独家精品文档,联系QQ:2885784924

肝移植的进展讲义.ppt

  1. 1、本文档共141页,可阅读全部内容。
  2. 2、原创力文档(book118)网站文档一经付费(服务费),不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
  3. 3、本站所有内容均由合作方或网友上传,本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺!文档内容仅供研究参考,付费前请自行鉴别。如您付费,意味着您自己接受本站规则且自行承担风险,本站不退款、不进行额外附加服务;查看《如何避免下载的几个坑》。如果您已付费下载过本站文档,您可以点击 这里二次下载
  4. 4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“版权申诉”(推荐),也可以打举报电话:400-050-0827(电话支持时间:9:00-18:30)。
查看更多
肝移植的进展;肝移植的发展现状;First orthotopic experimental liver replacement Transplant bulletin 3:7, 1956;Orthotopic Liver Transplantation; ;;;;;;;肝移植的发展现状;肝移植目前的现状(美国);Survival After LT;Previous: surgery, early graft dysfunction, immediate post-op care, allograft rejection Current: management of recurrent disease, long-term management of consequences of immunosuppression, eg, renal dysfunction, hypertension, diabetes, obesity, and dyslipidemia ;肝移植的发展现状;Patient Selection Criteria for LT;Liver Disease of Adult Recipients UNOS Database: 1990-92 vs 1995-96;导致肝移植的原发疾病: 病因学;导致肝移植的原发疾病:相关肿瘤;导致肝移植的原发疾病: 病理学;肝移植的适应症;慢性肝病的手术指征 ;绝对禁忌症;相对禁忌症;多发性肝囊肿;Allocation of organs: local ? regional ? national Acute liver failure (status I): first priority End-stage liver disease Listing: CTP score ? 7 (5 variables; range: 5-15) or episode of variceal bleed or SBP Allocation: MELD score (3 variables [INR, total bilirubin, creatinine]; range: 6-40) HCC Milan criteria (modified stage 2) Metabolic and cystic diseases Petition to Regional Review Board ;Deceased Donor Liver Allocation February 2002 Changes;MELD: Deceased Donor Liver Allocation;患者女性,41岁。 血型:A型。 2007年01月20日,患者因“左下腹痛伴发热4天”在外院诊断为“盆腔炎”行抗炎、对症治疗,01月22日6:00出现精神错乱、语无伦次,7:00出现昏迷、呼之不应伴鼾声,急查 ALT 3512u/L AST 1101u/L TB 153μmm0l/L HBsAg(+) HBeAb(+) HBcAb(+) PT 44s INR 3.6 MARS、血浆置换、血液滤过无效 ;Dilemmas in FLF Rapidly progressive illness Historically, FLF80% mortality, 20% survived Intensive medical management often futile Liver transplantation only “cure” 5.7% OLT for FLF Shortage of donor organ Death or complications often intervene;Recurrence of Disease After LT;Diseases That May Recur After LT;Liver transplantation is indicated for appropriately selected patients with decompensated cirrhosis secondary to chronic hepatitis B Continuous administration of HBIg after liver transplantation Diminishes reinfection rate Improves short-term survival compared with that of patients who underwent transplantation for other conditions However, HB

文档评论(0)

181****8523 + 关注
实名认证
内容提供者

该用户很懒,什么也没介绍

1亿VIP精品文档

相关文档