肝脏是人体最大的器官. 它位于腹部的右上部分,在胃的上方. 它的许多功能包括:

  • 加工蛋白质、脂肪和碳水化合物
  • 分解药物和酒精等有毒物质
  • 制造有助于血液凝结的化学成分
  • 排出一种叫做胆汁的黄色消化液

如果你的肝脏停止正常工作, you lose the ability to clot blood after an injury and to process the nutrients needed for life. 胆汁可能积聚,导致黄疸(黄色)眼睛和皮肤发痒.

Certain medications help treat liver failure symptoms, but there are no drugs that can cure it. Successful liver transplantation offers people with end-stage liver failure the chance to lead a longer, 更积极的生活.

资格

A liver transplant may not be recommended if you have an infection outside the liver, a medical condition that poses a problem or if you are an active substance abuser. Please contact us for more information on 加州大学旧金山分校健康's policy regarding liver transplants for patients with alcoholic liver disease.

病人 with a history of drug or alcohol dependency must remain drug- and alcohol-free for six months before transplant and agree to random screening tests.

患有某些癌症的人, 如转移性癌或胆管癌(胆管癌), or specific heart or lung conditions aren't candidates for liver transplantation.

继续阅读

评价

初步的评估, 叫做第一阶段评估, is the first step in determining if transplantation is an appropriate treatment option for you. 在评估期间, the transplant team also assesses the medical factors related to your liver failure.

预约要花一整天的时间,从早上7点开始.m. 4 p.m.,而且会很累. We ask that you bring at least one family member or other support person to help you process the significant amount of information you'll receive about the transplant process.

为你将要经历的考验做准备, 预约前一天午夜后不要吃或喝任何东西. 请将下列物品带到预约地点:

  • 零食
  • 你吃过什么药吗
  • 两种身份认同
  • 您的健康保险信息
  • 如果你有医疗记录的话

测试

在评估期间,您将接受一系列测试,包括:

  • 验血以确定肝脏和肾脏的工作状况
  • Ultrasound scan to view the blood flow to and from your liver and to look for any abnormal masses in the liver
  • 胸部x光检查肺部感染评估你的骨骼状况
  • 用心电图检查你的心跳是否有变化
  • 肺功能测试来测量你的肺活量

You'll also be evaluated by a liver specialist, called a hepatologist, and a surgeon. 肝科利来登录会给你做全面检查, 回顾您的健康史并讨论移植过程.

You can discuss your test results with the hepatologist and surgeon and ask any questions you have. Many patients find it helpful to write down a list of questions before the appointment.

You will also meet with a financial counselor to review your insurance information.

在世和已故的捐赠者

Liver transplantation can be performed using a portion of liver taken from either a deceased or a living donor. 后 活体供肝移植, both the donor's remaining liver lobe and the transplanted lobe grow to full size.

Living donors allow patients to receive a transplant without the sometimes lengthy wait for a liver from a deceased donor to become available.

During the transplant 评价, living donor transplantation will be discussed. 捐赠者必须身体健康, 有合适的血型,并想为利他主义捐献. 如果你有潜在的活体捐赠者, 他们的评估将在您完成所有测试后开始. 如果移植团队确定捐献能起作用, 我们会为你和你的捐赠者安排手术日期. 这个过程需要六个月的时间.

如果你愿意接受已故捐赠者的肝脏, 你会被列入全国等候名单直到有器官可用. 这可能发生在任何时间,白天或晚上. The wait for a new liver can take up to three years and you may need to repeat certain tests before your transplant.

如果肝脏移植对你不利的话, 移植小组的成员会打电话给你讨论其他选择.

社会工作的支持

Before your operation, a social worker will talk to you to about adjusting after the surgery. 社工每周领导 支持团体 for current and former transplant recipients and their families to address a wide range of issues, 在你住院期间,一对一的咨询也是可行的. If needed, a social worker can arrange follow-up services and answer questions about disability.

过程

Liver transplant surgery lasts about four to 12 hours depending on the patient's condition. Surgery often takes longer if the patient's had previous surgeries, due to scar tissue.

During surgery, your damaged liver and gallbladder will be removed and replaced with the donor liver. 你的胆囊不是必需的,也不会被替换.

复苏

After the transplant, you will be taken directly to the intensive care unit (ICU). 大多数病人只需要在重症监护室呆上一段时间.

在手术过程中,会插入一根呼吸管来帮助你呼吸. 在大多数情况下,手术后短时间内就可以取出导管. Many monitoring lines are attached during surgery; these, 太, 当你变得更稳定的时候会被移除吗. When you're ready to leave the ICU, you will be cared for in our transplant unit.

肝移植后的恢复情况因人而异. 病人通常要在利来登录里呆上5到10天. 你停留的时间长短取决于几个因素, 包括移植时你的病情, 你手术的复杂性以及你是否有任何并发症.

You should have a caregiver available both during your hospital stay and after discharge until you recover.

后续护理

等你出院了, 你首先会在肝脏移植诊所进行每周随访. 随着你的康复,你就不需要经常去看利来登录了. 如果你住在旧金山以外的地区, you'll likely need to find temporary lodging close to UCSF for the first month after discharge.

移植后你每周要验血两次. 渐渐地,这种情况会越来越少.

如果你需要调整药物,我们会通知你.

并发症和风险

任何手术都可能发生并发症, 接受过器官移植的患者可能会面临额外的风险. 肝移植可能的并发症包括:

  • 出血
    One of the liver's jobs is to make clotting factors that help stop bleeding after an injury. 当肝脏衰竭时,产生凝血因子的能力就会受损. To correct this problem, you'll receive blood products before and after surgery. It is expected that your new liver will start working very quickly to help prevent any excessive bleeding, but it is possible that you may be returned to surgery to control the bleeding, 尤其是在移植后48小时内.
  • 血栓形成
    If a blood clot forms in a vessel leading to or from your liver, it can injure your new liver. 这是一种严重的并发症,可能需要第二次移植. 你可以接受特殊的抗凝药物以防止血栓形成.
  • 拒绝
    你身体的免疫系统会保护你免受微生物入侵. Unfortunately, it also views your new liver as foreign and will try to destroy it to protect you. 这就是所谓的拒绝. To prevent this, you must take special immunosuppressive medication for the rest of your life.
  • 复发性疾病
    一些肝脏疾病在移植后会复发. 如果与你的案子有关,你的利来登录会和你讨论这个问题.

免疫抑制药物

免疫抑制药物, 也被称为抗排斥药物, 帮助预防和治疗排斥. 你的余生都需要服用这些药物. 手术后立即, the dosages will be high since the probability of rejection is greatest at this time. 如果没有排斥反应,我们会迅速降低您的剂量.

这些药物有副作用,其中一些与剂量有关. 病人 typically experience the most side effects right after transplantation, 当剂量最大时. 随着剂量的减少,副作用可能会减轻. 一些病人可能会出现副作用,而另一些则不会.

Be aware that anti-rejection medications also impair your body's ability to fight off infections. 我们会给你一些药物来预防感染, 但你需要小心,避免接触有感染的人, 特别是移植后的前三到六个月.