肝脏移植手术

评价

初步评价, 称为第一阶段评估, 第一步是确定移植是否适合你的治疗选择吗. 评估期间, 移植团队还会评估与肝功能衰竭相关的医学因素.

The appointment takes a full day, from about 7 a.m. 到下午4点.m.而且会很累. 我们要求你至少带一个家庭成员或其他支持人员来帮助你处理你将收到的关于移植过程的大量信息.

为你将要接受的测试做准备, do not eat or drink anything after midnight the day before your appointment. Please bring these items to your appointment:

• 零食
• 你服用过什么药物吗?
• 两种形式的识别
• 您的健康保险信息
• 你的医疗记录，如果有的话

测试

You'll undergo a series of tests during your evaluation, including:

• Blood tests to determine how well your liver and kidneys are working
• 超声波扫描，观察血液流向和流出你的肝脏，并寻找肝脏中任何异常的肿块
• Chest X-ray to look for lung infection and to assess the status of your bones
• Electrocardiogram to look for any changes in your heart rhythm
• Pulmonary function test to measure your lung capacity

你还会接受肝脏专家和外科十大赌博平台排行榜的评估. The hepatologist will perform a full exam, review your health history and discuss the transplantation process.

您可以与肝病专家和外科十大赌博平台排行榜讨论您的检查结果，并提出您的任何问题. 许多病人发现在预约前写下问题清单很有帮助.

您还将与财务顾问会面，以审查您的保险信息.

在世和已故捐赠者

肝移植可以使用从死者或活体供者身上取下的部分肝脏进行. 后 活体供肝移植，供者的剩余肝叶和移植的肝叶都会长到完全大小.

活体捐献者允许患者接受移植手术，而不需要等待已故捐献者的肝脏，有时需要等待很长时间.

在移植评估中，将讨论活体供体移植. 捐赠者必须身体健康, have a compatible blood type and want to donate for altruistic reasons. 如果你有潜在的活体捐献者, their evaluation will begin after you've completed all your testing. If the transplant team determines that the donation would work, a surgery date will be scheduled for both you and your donor. 这个过程需要六个月的时间.

If you will receive a liver from a deceased donor, you'll be placed on a national waiting list until an organ becomes available. 这可能发生在任何时间，白天或晚上. 等待一个新的肝脏可能需要长达三年的时间，你可能需要在移植前重复某些测试.

If a liver transplant isn't in your best interest, a transplant team member will call you to discuss other options.

社会工作支持

在你的手术之前，社工会和你谈谈手术后的调整. 社工每周领导一次 支持团体 为现在和以前的移植受者及其家属解决广泛的问题, and one-on-one counseling is also available during your hospital stay. 如果需要，社工可以安排后续服务，并回答有关残疾的问题.

过程

根据病人的情况，肝移植手术大约需要4到12个小时. 如果病人以前做过手术，由于疤痕组织，手术通常需要更长的时间.

在手术中，你受损的肝脏和胆囊将被切除，并由供体肝脏代替. Your gallbladder isn't necessary and won't be replaced.

复苏

移植后，您将被直接送往重症监护病房(ICU)。. Most patients need only a brief stay in the ICU.

During surgery, a breathing tube is inserted to help you breathe. In most cases the tube can be removed shortly after surgery. Many monitoring lines are attached during surgery; these, 太, will be removed as you become more stable. 当你准备好离开重症监护室时，你将在我们的移植病房接受治疗.

Everyone recuperates from liver transplantation differently. 病人 typically spend five to 10 days in the hospital. The length of your stay will depend on a number of factors, including how sick you are at the time of transplant, the complexity of your operation and if you experience any complications.

在你住院期间和出院后，直到你康复，你都应该有一个照顾者.

后续护理

一旦你出院了, you'll initially have weekly follow-up visits at the 肝脏移植手术 Clinic. As you recover, you'll need to be seen less frequently. If you live outside the San Francisco area, 出院后的第一个月，你可能需要在加州大学旧金山分校附近找个临时住所.

You'll have blood tests twice a week following transplantation. Gradually, these will become less frequent.

You'll be notified about any adjustments you need to make to your medications.

并发症和风险

任何手术都可能出现并发症, and patients who've had an organ transplant may face additional risks. Possible complications of a liver transplant include:

• 出血
  肝脏的工作之一是产生凝血因子，帮助在受伤后止血. When the liver fails, the ability to produce clotting factors is impaired. 为了纠正这个问题，你会在手术前后接受血液制品. 预计你的新肝脏会很快开始工作，以帮助防止任何过多的出血, 但你也有可能需要做手术来控制出血, particularly if it occurs within 48 hours after the transplant.
• 血栓形成
  如果血液凝块在通往或离开肝脏的血管中形成，它会损伤你的新肝脏. This is a serious complication that may require a second transplant. You may receive special anticoagulation medication to prevent thrombosis.
• 拒绝
  Your body's immune system protects you from invading organisms. 不幸的是，它也认为你的新肝脏是外来的，并会试图摧毁它来保护你. 这就是所谓的拒绝. 为了防止这种情况，你必须终生服用特殊的免疫抑制药物.
• 复发性疾病
  Some liver diseases can come back after a transplant. Your provider will discuss this with you if it's relevant to your case.

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. You will need to take these medications for the rest of your life. 手术后立即, 由于此时排异反应的可能性最大，所以剂量会很高. We will lower your dosage quickly if there are no signs of rejection.

These medications have side effects, some of which are dose-related. 患者在移植后通常会经历最多的副作用, 当剂量最高时. As your dosage is lowered, the side effects will probably lessen. Side effects may occur in some patients and not in others.

要知道，抗排斥药物也会损害你身体抵抗感染的能力. You'll be given medication to help prevent infections, but you'll need to use caution and avoid contact with people with infections, especially during the first three to six months after transplant.