肝移植术后急性肾损伤的诊断与治疗  

Diagnosis and treatment of acute kidney injury after liver transplantation

作　　者：蔡金贞 李志强[1] 许传屾[1] 赵凯[1] 戴德淑 王新[1] Cai Jinzhen;Li Zhiqiang;Xu Chuanshen;Zhao Kai;Dai Deshu;Wang Xin(Organ Transplant Center of the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院器官移植中心,青岛266000

出　　处：《器官移植》2023年第4期473-478,共6页Organ Transplantation

基　　金：山东省自然科学基金(ZR2022MH292);山东省学校卫生协会2022年度科研课题(SDWS2022070);青岛大学医学部“临床医学+X”工程科研项目(2017225);青岛大学附属医院“临床医学+X”科研项目(QYFY+X202101060)。

摘　　要：急性肾损伤是肝移植术后常见的并发症,严重影响肝移植受者的预后。肝移植术前、术中和术后的多种因素均可引起肾损伤,如未进行妥善处理,可进展为慢性肾病,显著增加术后病死率,对肝移植的临床疗效产生负面影响。因此,肝移植术后急性肾损伤的预防、诊断及治疗是临床医师研究的热点。本文从急性肾损伤的定义,肝移植术后急性肾损伤的诊断、危险因素、预防及处理等几个方面进行综述,探讨肝移植术后急性肾损伤发生发展的各个阶段可能存在的危险因素及相关治疗策略,旨在通过优化治疗方案,降低肝移植术后急性肾损伤的风险,进一步改善肝移植受者的临床预后。Acute kidney injury is a common complication after liver transplantation,which severely affects clinical prognosis of liver transplant recipients.Multiple factors before,during and after liver transplantation may cause kidney injury.If not properly treated,it may progress into chronic kidney diseases,which significantly increases postoperative fatality and negatively affects clinical efficacy of liver transplantation.Therefore,prevention,diagnosis and treatment of acute kidney injury after liver transplantation is a hot topic for clinicians.In this article,the definition,diagnosis,risk factors,prevention and treatment of acute kidney injury after liver transplantation were reviewed,and potential risk factors and related therapeutic strategies during different stages of acute kidney injury after liver transplantation were analyzed,aiming to lower the risk of acute kidney injury after liver transplantation and further improve clinical prognosis of liver transplant recipients by optimizing treatment regimens.

关 键 词：肝移植 急性肾损伤 慢性肾病 血清肌酐 肾小球滤过率 免疫抑制药 持续性肾脏替代治疗 缺血-再灌注损伤 

分 类 号：R617[医药卫生—外科学] R692[医药卫生—临床医学]