在急性-慢性肝衰竭 (ACLF) 设置中进行心肝联合移植
Deepali Dahale1, Aditya Kunte2, Sandeep Sinha3
1Critical Care-Liver Transplant, Department of GI & Hepatobiliary Sciences, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, India.
Indian journal of thoracic and cardiovascular surgery
|February 12, 2026
概括
本案例报告详细介绍了第一个针对急性至慢性肝衰竭 (ACLF) 的心脏和肝脏联合移植 (CHLT) 病例. 成功的程序突显了CHLT在复杂的双器官故障场景中的可行性.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
背景情况:
- 结合心脏和肝脏移植 (CHLT) 是同时发生双器官衰竭的罕见手术.
- 这位患者出现了缺血性心肌病,严重的充血性心力衰竭和二次急性至慢性肝衰竭 (ACLF).
- 以前的治疗方法,包括最大限度的医疗治疗和自动植入式心脏转换器-除器 (AICD) 植入不够.
研究的目的:
- 报告第一个针对ACLF二次至高级心力衰竭进行的CHLT病例.
- 描述这样一个病例的复杂的外科手术和术后管理.
- 为了证明CHLT在这个具有挑战性的临床环境中的可行性和结果.
主要方法:
- 一名58岁的男性患有末期心脏和肝功能衰竭,同时接受了 ортотоп CHLT.
- 该程序涉及从双心室辅助装置 (BiVAD) 过渡到心肺旁路 (CPB) 进行器官植入.
- 术后管理包括解决诸如感染,毒性和危急疾病肌肉病变等并发症.
主要成果:
- 患者在复杂的CHLT手术中幸存下来,移植后3个月就出院了.
- 移植后5个月,患者表现出正常的双心脏和肝功能,没有排斥迹象.
- 成功管理了手术后并发症,包括细胞巨乳病毒 (CMV) 感染和多药耐药性败血症.
结论:
- 对于二次至高级心力衰竭的ACLF患者来说,CHLT是一种可行的治疗选择.
- 多学科的方法对于管理与CHLT相关的复杂的外科手术挑战至关重要.
- 这一案例强调了在罕见而复杂的双器官移植场景中取得成功结果的潜力.
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