Mentha G, Le Coultre C, Huber O, Meyer P, Belli D, Klopfenstein C, Kowalski M, Rohner A
Clinique de chirurgie digestive, Hôpital cantonal universitaire, Genève.
Schweiz Rundsch Med Prax. 1991 Dec 3;80(49):1380-7.
Indications for and results of orthotopic liver transplantation (OLT) were modified over the past ten years by new immunosuppressive agents, earlier timing of transplantation and better knowledge of potential complications. In 1990, OLT appears justified in the treatment of all liver disease threatening life, in the absence of contraindications and other possible treatments. Between July 1987 and December 1990, 21 patients were transplanted at the Geneva University Hospital. Three children received part of an adult liver (two or three segments), using the reduced-size liver transplantation technique. Four OLTs had to be performed in an emergency situation. Two patients died within six months of transplantation, one after 7.5 months, and the last patient died after one year from cancer recurrence. 17 patients are presently alive (81%) at 4 to 39 months (median 14 months) following OLT. More than the mere survival, however, the quality of life regained after transplantation prompts us to consider transplantation early in the progress of the disease.
在过去十年中,由于新型免疫抑制剂的出现、移植时机的提前以及对潜在并发症的更深入了解,原位肝移植(OLT)的适应证和结果发生了改变。1990年,在没有禁忌证和其他可能治疗方法的情况下,OLT似乎适用于所有威胁生命的肝脏疾病的治疗。1987年7月至1990年12月期间,日内瓦大学医院有21例患者接受了肝移植。3名儿童接受了成人肝脏的部分移植(两或三段),采用了减体积肝移植技术。4例OLT必须在紧急情况下进行。2例患者在移植后6个月内死亡,1例在7.5个月后死亡,最后1例患者在移植1年后因癌症复发死亡。17例患者目前在OLT后4至39个月(中位时间14个月)仍存活(81%)。然而,移植后恢复的生活质量不仅仅是生存问题,这促使我们在疾病进展早期就考虑进行移植。