当肝切除术后肝功能衰竭（PHLF）被认为是不可逆转且可能致命时，抢救性肝移植（LT）是唯一挽救生命的选择。目标是对 PHLF 的救援 LT 进行定性系统评价，并对各个国际 LT 专家进行调查。使用系统评价和荟萃分析以及人群、干预、比较的首选报告项目从 2000 年到 2022 年进行了文献检索，结果框架，并在此基础上添加了作者的经验。国际在线公开调查包括从文献中提取的 6 个 PHLF 病例，提交给 976 名 LT 专家。主要结果是专家是否会考虑对每个病例​​进行挽救性肝移植。使用自由边际多评估者 kappa 方法计算专家之间的评估者间一致性。该评价包括 40 名患者。 LT 后死亡发生在 8 例 (20%) 病例中（7/28 为确诊癌症，1/12 为良性疾病）。从长远来看，21 名癌症幸存者中有 6 名 (28.6%) 死于复发（中位 = 38 个月），15 名 (71.4%) 存活且没有复发（中位 = 111 个月）。所有 11 名患有良性疾病的幸存者均存活且状况良好（中位 = 39 个月）。在国际 LT 专家调查中，考虑挽救 LT 的同意百分比为 28%-98%，良性疾病高于恶性疾病（P = 0.011）。主要终点的评估者间一致性较低，预期 5 年生存率 >50% 是考虑 LT 的最强独立预测因素。针对 PHLF 的救援 LT 可能在选定的患者中取得良好的结果。在考虑对 PHLF 进行 LT 时，LT 专家的决策存在相当大的不一致。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Rescue liver transplantation (LT) is the only life-saving option for posthepatectomy liver failure (PHLF) whenever it is deemed as irreversible and likely to be fatal. The goals were to perform a qualitative systematic review of rescue LT for PHLF and a survey among various international LT experts.A literature search was performed from 2000 to 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Population, Intervention, Comparison, Outcome framework, and to this, the authors' experience was added. The international online open survey included 6 cases of PHLF extracted from the literature and submitted to 976 LT experts. The primary outcome was whether experts would consider rescue LT for each case. Interrater agreement among experts was calculated using the free-marginal multirater kappa methodology.The review included 40 patients. Post-LT mortality occurred in 8 (20%) cases (7/28 with proven cancer and 1/12 with benign disease). In the long term, 6 of 21 (28.6%) survivors with cancer died of recurrence (median = 38 mo) and 15 (71.4%) were alive with no recurrence (median = 111 mo). All 11 survivors with benign disease were alive and well (median = 39 mo). In the international survey among experts in LT, the percentage agreement to consider rescue LT was 28%-98%, higher for benign than for malignant disease (P = 0.011). Interrater agreement for the primary endpoint was low, expected 5-y survival >50% being the strongest independent predictor to consider LT.Rescue LT for PHLF may achieve good results in selected patients. Considerable inconsistencies of decision-making exist among LT experts when considering LT for PHLF.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.