Mazziotti A, Cescon M, Grazi G L, Nardo B, D'Errico A, Ercolani G, Cavallari A
Department of Surgery and Transplantation, University of Bologna, Policlinico S. Orsola, Italy.
Hepatogastroenterology. 1999 May-Jun;46(27):1819-22.
The increasing number of patients listed for liver transplantation and the persistent low number of potential donors have led, in recent years, to the expansion of organ availability, as is the case of liver procurement from elderly donors. So far, results reported in the literature are controversial and only a few reports described satisfactory outcomes of transplantation using donors older than 60 years. In the case presented herein, we report the successful elective liver transplantation of a 65 year-old patient, who received a graft from an 87 year-old donor, whose well-preserved hemodynamic conditions, normal hepatic function, absence of parenchymal alterations, as well as short ischemia time, were the key points for this good outcome. Even very old donors can be suitable for liver transplantation. A careful evaluation of all the possible donor-related risk factors, mostly the presence of steatotic changes at liver biopsy, is always mandatory.
近年来,等待肝移植的患者数量不断增加,而潜在供体数量持续偏低,这导致了器官可利用范围的扩大,比如从老年供体获取肝脏的情况。到目前为止,文献报道的结果存在争议,只有少数报告描述了使用60岁以上供体进行移植的满意结果。在本文所呈现的病例中,我们报告了一例65岁患者成功接受择期肝移植的案例,该患者接受了一位87岁供体的肝脏,供体保存良好的血流动力学状况、正常的肝功能、无实质改变以及较短的缺血时间是取得良好结果的关键因素。即使是非常高龄的供体也可能适合肝移植。对所有可能与供体相关的危险因素进行仔细评估,尤其是肝活检时脂肪变性改变的存在情况,始终是必不可少的。