Müller Sascha A, Mehrabi Arianeb, Schmied Bruno M, Welsch Thilo, Fonouni Hamidreza, Engelmann Guido, Schemmer Peter, Weitz Jürgen, Schmidt Jan
Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D - 69120 Heidelberg, Germany.
Nephrol Dial Transplant. 2007 Sep;22 Suppl 8:viii13-viii22. doi: 10.1093/ndt/gfm653.
In the last two decades, liver transplantation (LTx) has become the treatment of choice for several liver diseases including hepatocellular carcinoma in selected cases. Improvements in surgical and anesthesiological procedures have increased patient survival after LTx, resulting in excellent 1-year survival rates. The rate-limiting factor to further increase the number of LTx is the extreme shortage of suitable organs with the consequence that pediatric and adult patients are dying on the waiting list. At present, mortality reported for pediatric and adult patients on the waiting list is 10 to 20%. Living-donor liver transplantation and split liver transplantation are measurements to reduce the severe lack of cadaveric grafts by expanding the donor pool. Major centers around the world now routinely perform partial LTx in infants and adults with survival success equivalent to that after full-size liver transplantation.
在过去二十年中,肝移植(LTx)已成为包括特定病例中的肝细胞癌在内的多种肝脏疾病的首选治疗方法。手术和麻醉程序的改进提高了肝移植术后患者的生存率,1年生存率极佳。进一步增加肝移植数量的限制因素是合适器官极度短缺,结果导致儿童和成人患者在等待名单上死亡。目前,报告的等待名单上儿童和成人患者的死亡率为10%至20%。活体供肝肝移植和劈离式肝移植是通过扩大供体库来减少尸体供肝严重短缺的措施。现在,世界各地的主要中心常规地对婴儿和成人进行部分肝移植,其生存成功率与全尺寸肝移植后的相当。