ABSTRACT
A falência hepática fulminante (FHF) é uma síndrome clínica com alta morbidade e mortalidade. A disfunção de múltiplos órgãos apresentada pelos pacientes com FHF é um dos mais intrigantes problemas do manejo em medicina clínica e requer cooperação entre intensivistas, neurologistas, hepatologistas e cirurgiões de transplante. A única intervenção terapêutica que provê benefício definitivo nos pacientes com falência hepática aguda avançada é o transplante de fígado de emergência.
The fulminant hepatic failure (FHF) is a clinical syndrome associated with high morbidity and mortality. The multiorgan dysfunction presented by patient with FHF is one of the most challenging management problems in clinical medicine and require very close cooperation in clinical medicine, the meurologist, and the hepatologist and transplant surgeon's. The only therapeutic intervention of proven benefit for patients with advanced acute liver failure is the emergency liver transplantation. We performed a retrospective analysis of patients with FHF and submited for liver transplantation at the Oswaldo Cruz University Hospital, Pernambuco University.
Subject(s)
Humans , Liver Failure/surgery , Liver Failure/etiology , Liver Failure/physiopathology , Hepatitis/surgery , Hepatitis/complications , Hepatitis/physiopathology , Transplantation , Liver Transplantation/statistics & numerical data , Liver Transplantation/methods , Liver TransplantationABSTRACT
In the last few years, there have been developments In many aspects of liver transplantation. Improvements in surgical techniques and immunosuppression markedly increased the success rates of liver transplantation. This success has lead to increasing numbers of recipients. However, the availability of cadaveric organs for transplantation has not been changed in the last 10 years, resulting in a growing discrepancy between donors and recipients. Thus, it is necessary to properly select the best candidates for a successful liver transplant. This article will review the indications and contraindications for liver transplantation in the Model for End Stage Liver Disease (MELD) score era.
En los últimos años han existido avances importantes en el trasplante hepático. La evolución en la cirugía hepática y la aparición de mejores inmunosupresores han incrementado de manera importante el éxito en el trasplante hepático. Este éxito ha aumentado el número de receptores; sin embargo, al mismo tiempo el número de órganos ha permanecido estable en los últimos 10 años, teniendo como resultado un incremento en la disparidad entre donadores y receptores. Por lo tanto es necesario conocer quiénes son los mejores candidatos para un trasplante hepático. En este artículo se revisarán las indicaciones y contraindicaciones en el trasplante hepático en la era de la clasificación de MELD (por sus siglas en inglés Model for End Stage Liver Disease).