Category: Resident

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Posted on in Medical student, Resident

台大醫科醫五肝移植課程綱要 (Curriculum Guideline of Liver Transplantation for Undergraduates in National Taiwan University)

學習目標 (Key Qs)：

  1. Indication and contraindication of liver transplantation in the real-world clinical setting (碰到一個病人，我怎麼知道要不要作肝臟移植的準備工作? 這個人可能同時有適應症及禁忌症怎麼辦?)
  2. MELD score and organ allocation in liver transplantation (大愛肝臟怎麼分配? 世界上每個地方原則都一樣嗎)
  3. Liver transplantation for HCC and other malignancies (肝臟惡性腫瘤可以作移植嗎? 可以人為做些努力讓不能移植的病人去接受移植嗎?)
  4. Immunosuppression in liver transplantation (肝移植後的免疫抑制劑有哪些，使用原則? 不論何時，一輩子都不變嗎?)
  5. Antiviral treatment in liver transplantation (肝移植前後的B/C型肝炎病毒需要治療嗎?處理原則? 要治療多久?) (請注意期刊文獻上HCV 治療建議的時效性)

—請根據學習目標問題從參考文獻中(或自行搜尋)找出合理的原則解釋(不用看完全文)，並於課堂上精要發表5 min及討論—

課後考題 (Homework assay) (課後一周內網路繳交A4 (1面以內)至drcmho@ntu.edu.tw)

一位55 歲男性病人有C型肝炎、肝硬化及肝癌來求診，身為醫師的你，要如何利用現有醫療水準提出治療建議？(How do you, as a doctor, suggest the management strategy for a 55 year-old male patient with hepatitis C viral infection, liver cirrhosis and hepatocellular carcinoma?)

成績計算方式

課堂表現80%, 課後考題20%

課綱 (guide)

Succinct guide to liver transplantation for medical students.  http://dx.doi.org/10.1016/j.amsu.2016.11.004

Suggested References (參考資料)

  1. Liver transplantation http://www.uptodate.com/contents/table-of-contents/gastroenterology-and-hepatology/liver-transplantation (UpToDate)
  2. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Liver transplantation. J Hepatol. 2016 Feb;64(2):433-85. (歐洲肝移植建議)
  3. 台灣器官移植條例及附表 http://www.torsc.org.tw/transplant/transplant_02.jsp (台灣現行規定)
  4. http://www.hepatitisc.uw.edu/level3.php?level3=58 (HCV 治療線上資料庫)
  5. Neuberger J. An update on liver transplantation: A critical review.  An update on liver transplantation: A critical review. J Autoimmun. 2016 Jan;66:51-9. (肝移植的展望)
  6. Mazzaferro V, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996;334: 693-9. (Milan Criteria 經典之作)

  7. Lee SG.  A complete treatment of adult living donor liver transplantation: a review of surgical technique and current challenges to expand indication of patients. Am J Transplant 2015 Jan;15(1):17-38. (活體肝移植手術技術大補帖)

    * Hepatitis C Virus—From Discovery to Cure:  The 2016 Lasker-DeBakey Clinical Medical Research Award | Sep 27, 2016 | JAMA  http://jama.jamanetwork.com/article.aspx?articleid=2552662 (有HCV藥物發展導引簡介)