Fuster Josep, Charco Ramón, Llovet Josep M, Bruix Jordi, García-Valdecasas Juan Carlos
Barcelona-Clinic Liver Cancer (BCLC) Group, Department of Surgery, Digestive Disease Institute, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Villaroel 170, 08036 Barcelona, Catalonia, Spain.
Transpl Int. 2005 Mar;18(3):278-82. doi: 10.1111/j.1432-2277.2004.00046.x.
Liver transplantation is one option of surgical treatment for cirrhotic patients with hepatocellular carcinoma, it not only treats the malignancy but also the underlying disease. After an initial period of disappointing results, mainly due to lack of adequate selection, survival nowadays is similar to that obtained by cirrhotic patients without tumor. Currently the scarcity of donors is the main limitation in the treatment of this type of patients. Increased time on the waiting list does compromise the results if they are analyzed in an intention-to-treat basis. Adjuvant therapy on the waiting list (ethanol injection, chemoembolization, surgery, etc.) or the use of marginal grafts in order to increase the donor pool may be some alternatives to overcome this deficit. The development of adult living donor liver transplantation has proved to be a good alternative in this type of patients even if they do not fulfill the conventional criteria.
肝移植是肝硬化合并肝细胞癌患者的一种外科治疗选择，它不仅能治疗恶性肿瘤，还能治疗潜在疾病。在经历了最初一段令人失望的结果期后，主要原因是缺乏充分的选择，如今肝硬化合并肝细胞癌患者的生存率与无肿瘤的肝硬化患者相似。目前，供体稀缺是这类患者治疗的主要限制因素。如果按照意向性分析，等待名单上时间的增加确实会影响治疗结果。等待名单上的辅助治疗（乙醇注射、化疗栓塞、手术等）或使用边缘供肝以增加供体库可能是克服这一不足的一些替代方法。成人活体肝移植的发展已被证明是这类患者的一个良好替代选择，即使他们不符合传统标准。
