肝移植病人牙的管理

谷雨

经常看到有肝友咨询肝移植后遇到牙病治疗或者洁牙中需要注意的问题。在这里我将自己在加拿大看牙医时，移植医生传真给我的牙医的有关注意事项传上来，仅让大家作些了解和参考(遇到任何问题，请咨询自己的移植医生和牙医，千万不要自己贸然处理！）。因本人不具备足够的医学知识，恐引起误导，不敢冒然翻译成中文，还请哪位高手帮忙翻译一下。
Dear Dentists and Oral Surgeons,

This Letter is to alert you to the recommendations of The Liver Transplant Program,医院名，regarding the dental management of our liver transplant patients.

Most liver transplant patients have normal liver function and coagulation once they are six months following their liver transplant. We will attach the most current biochemistry and coagulation results.

As you know, viral Hepatitis B and C are indications for liver transplantation. There are most certainly other hepatitis viruses that have not been “discovered” that are the cause of the end-stage liver disease in our patients. We therefore advise that you take hepatitis precautions in patients who have a history of hepatitis B or C. you should consider that this virus persist in these patients after their liver transplant.

We do not recognize that our patients have an increased risk of infectious complications following routine dental procedures over that of the normal population. While our patients are on long-term immunosuppression the doses that are used in our patients have not predisposed them bacterial complications related to dental procedures.

We don not recommend the routine use of prophylactic antibiotics for liver transplant patients. We would however, leave at your discretion, the appropriate decision as to whatever prophylactic antibiotics are required on an individual basis. Certainly the standard indications for prophylaxis should be follows as per the CDA guidelines.

In patients who require antibiotic prophylaxis, we recommend the use of ampicillin, Amoxicillin, Gentamicin, Clindamycin, or Vancomycin. It is important to avoid the use of Erythromycin or other macrolide antibiotics, as they interfere with the metabolisim of Cyclosporine or Tacrolimus which may result in increased levels and increased toxicity.

Many of our patients have considerable gingival hyperplasia second to the Cyclosporine. In patients for whom this is problematic a resection of this hypertrophic tissue may be appropriate.

If you have any questions or concerns regarding our mutual patient, please contact the primary liver transplant coordinator for your patient.
传真后面还附有生化和血常规的检查结果.

kql

先放上两段机器人的翻译，大家稍微对照一下，马马虎虎看看吧。稍后谁精通的翻译吧。