肝脏移植手术

评价

初步评价, 称为第一阶段评估, is the first step in determining if transplantation is an appropriate treatment option for you. 评估期间, the transplant team also assesses the medical factors related to your liver failure.

预约需要一整天，从早上7点开始.m. 到下午4点.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.

为你将要接受的测试做准备, 在预约前一天午夜之后不要吃或喝任何东西. 请在预约时带上这些物品:

• 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

在评估期间，您将接受一系列测试，包括:

• 验血来确定你的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光检查肺部感染和评估骨骼状况
• 做心电图检查心律是否有变化
• 肺功能测试，测量你的肺活量

You'll also be evaluated by a liver specialist, called a hepatologist, and a surgeon. 肝病专家将进行全面检查, 回顾你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 evaluation, living donor transplantation will be discussed. 捐赠者必须身体健康, 血型相容，想要出于无私的原因献血. 如果你有潜在的活体捐献者, 他们的评估将在你完成所有测试后开始. 如果移植团队确定捐赠是有效的, 我们会为你和你的捐赠者安排一个手术日期. 这个过程需要六个月的时间.

如果你将接受来自已故捐赠者的肝脏, 你会被列在全国等候名单上直到找到合适的器官. 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.

如果肝脏移植不符合你的利益, 移植团队的成员会打电话给你讨论其他选择.

社会工作支持

Before your operation, a social worker will talk to you to about adjusting after the surgery. 社工每周领导一次 支持团体 for current and former transplant recipients and their families to address a wide range of issues, 在您住院期间，我们还提供一对一的咨询服务. 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短暂停留.

在手术中，插入一根呼吸管来帮助你呼吸. 在大多数情况下，试管可以在手术后不久取出. Many monitoring lines are attached during surgery; these, 太, 会在你变得更稳定时被移除吗. When you're ready to leave the ICU, you will be cared for in our transplant unit.

每个人从肝移植中恢复的情况都不一样. 患者通常在十大赌博平台排行榜呆5到10天. 你逗留的时间长短取决于许多因素, 包括移植时你的病情, 你手术的复杂性，如果你遇到任何并发症.

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

后续护理

一旦你出院了, 一开始你每周都要去肝移植诊所随访. 等你康复了，你就不用那么频繁地去看十大赌博平台排行榜了. 如果你住在旧金山地区以外, you'll likely need to find temporary lodging close to UCSF for the first month after discharge.

移植后你每周要做两次血液检查. 渐渐地，这种情况会变得不那么频繁.

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, 接受过器官移植的患者可能会面临额外的风险. 肝移植可能出现的并发症包括:

• 出血
  One of the liver's jobs is to make clotting factors that help stop bleeding after an injury. 当肝脏功能衰竭时，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. 这是一个严重的并发症，可能需要第二次移植. 你可能需要特殊的抗凝药物来防止血栓形成.
• 拒绝
  你身体的免疫系统保护你免受入侵的生物. 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. 如果与您的情况相关，您的提供者将与您讨论.

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. 你将需要在你的余生中服用这些药物. 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，我们会迅速降低你的剂量.

这些药物都有副作用，其中一些与剂量有关. 病人 typically experience the most side effects right after transplantation, 当剂量最高时. 随着剂量的减少，副作用可能会减轻. 副作用可能发生在一些病人身上，而不是在其他病人身上.

Be aware that anti-rejection medications also impair your body's ability to fight off infections. 十大赌博平台排行榜会给你开一些药物来预防感染, 但你需要小心，避免与感染者接触, 尤其是在移植后的前三到六个月.