肝移植术后早期急性肾功能衰竭5例临床分析

目的总结肝移植术后早期急性肾功能衰竭的防治经验。方法回顾性分析5例肝移植受者术后早期发生急性肾功能衰竭临床资料，手术方式为改良背驮式肝移植术，其中4例术前即合并肾功能不全。结果5例术后早期急性肾功能衰竭患者3例通过调整免疫抑制方案和改善肾脏灌注及利尿治疗肾功能恢复；2例给予连续性肾脏替代治疗后肾功能恢复。结论肝移植术后免疫抑制剂的个体化应用，积极改善肾脏灌注，必要时选择血液透析治疗，有助于防治肝移植术后早期急性肾功能衰竭。

Clinical analysis of early acute renal failure following orthotopic liver transplantation

Objective To summarize the experience of prophylaxis and treatment of acute renal failure (ARF) in patients after orthotopic liver transplantation (OLT).Methods Clinical data of 5 patients of early ARF following OLT from the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Modified piggyback procedures were applied in all cases. Four of them were combined with renal dysfunction before surgery.Results ARF in 3 of the 5 patients was corrected by individualized immunosuppressive regimens, improving renal perfusion, and using diuretic, and through consecutive renal replacement therapies in other 2 patients.Conclusion Individualized immunosuppressive regimen, improving renal perfusion therapy, and hemodialysis can prevent early ARF after OLT.