中国肝移植术后并发症诊疗规范（2019版）

第12卷，第2期器官移植Vol.12 No.22021年3月Organ TransplantationMar.2021·诊疗规范·中国肝移植术后并发症诊疗规范(2019版)中华医学会器官移植学分会【摘要】肝移植手术技术日臻成熟，效果确定，但术后仍可能发生移植肝无功能、术后出血及胆道并发症等，影响受者长期存活。为进一步规范肝移植术后并发症诊疗，中华医学会器官移植学分会组织肝移植专家，总结国内外相关研究最新进展，并结合国际指南和临床实践，针对肝移植术后并发症的诊断与治疗，制订《中国肝移植术后并发症诊疗规范(2019版)》。【关键词】肝移植；并发症；诊断；治疗【中图分类号】R617,R619【文献标志码】A【文章编号】1674-7445(2021)02-0002-05Diagnosis and treatment specification for postoperative complications after liver transplantation in China (2019 edition)Branch ofOrgan Transplamntation of Chinese Medical Association.Xijing Hospital ofAir Force Medical University.Xi'an 710032.ChinaCorresponding author:Tao Kaishan,Email:taokaishan0686@163.com[Abstraet]The surgical techniques of liver transplantation are increasingly sophisticated with the definiteeffect.However,postoperative complications,such as liver graft nonfunction,postoperative bleeding and biliary tractcomplication may still occur,which may affect the long-term survival of the recipients.To further standardize thediagnosis and treatment of postoperative complications after liver transplantation,Branch of Organ Transplantation ofChinese Medical Association organized liver transplant experts to summarize the latest research progress at home andabroad,integrate international guidelines and clinical practice and formulate the "Diagnosis and treatment specification forpostoperative complications after liver transplantation in China (2019 Edition)"based upon the diagnosis and treatment ofpostoperative complications after liver transplantation.[Key words]Liver transplantation;Complication;Diagnosis;Treatment随着肝移植技术的不断完善，受者5年生存率相比，肝移植术后PF的发生率并不高，文献报道已达70%~85%，但术后各类并发症的发生率约为约为0.6%-10.0%)，然而一旦发生只能行二次肝移植，14%~35%,仍是影响受者生存质量、受者和移植肝否则病死率高达100%。长期存活的重要危险因素口。1.1病因1原发性移植物无功能(primaryPNF是多种病理过程共同作用的结果，其病因和发生机制尚未完全明确，可能与以下3方面因素nonfunction,PNF)有关。PNF是肝移植术后早期最为严重的并发症之一1.1.1供者相关因素年龄>50岁；严重脂肪肝（供肝往往危及受者生命，导致移植失败冈。与其他并发症脂肪变性>60%)；术前供者低血压、低氧血症以及D0L:10.3969j.is5sn.16747445.2021.02.002作者单位：710032西安，空军军医大学西京医院通信作者：陶开山，Email:taokaishan0686@163.com