Imagawa D K, Strange S M, Shaked A, Seu P, Colonna J O, Farmer D, McDiramid S V, Morrissey M P, Busuttil R W
Department of Surgery, UCLA School of Medicine.
Clin Transpl. 1991:127-34.
Liver transplantation remains the treatment of choice for many forms of end-stage liver disease. In most large series, 5-year actuarial survival is greater than 70%. The majority of the morbidity and mortality occurs in the first 6 months posttransplant; as these figures have improved, so have overall survival rates. Infants under 1 year of age have a survival rate below that of older patients; in addition, a severe organ shortage for these patients continues. The use of reduced grafts has ameliorated the problem to a certain extent; however, further expansion of the donor pool is still necessary. Progress has also been made in the postoperative management of transplant patients. We currently follow AKBR and TNF levels in all patients to aid in the diagnosis of primary nonfunction and acute rejection, respectively. The introduction of additional immunosuppressive agents has instigated several large clinical trials. CsA, however, remains the gold standard to which these drugs must be compared.
肝移植仍然是多种终末期肝病的首选治疗方法。在大多数大型研究系列中，5年精算生存率大于70%。大多数发病和死亡发生在移植后的前6个月；随着这些数据的改善，总体生存率也有所提高。1岁以下的婴儿生存率低于老年患者；此外，这些患者严重的器官短缺问题仍然存在。使用减体积移植物在一定程度上缓解了这一问题；然而，进一步扩大供体库仍然是必要的。移植患者的术后管理也取得了进展。我们目前对所有患者监测AKBR和TNF水平，分别有助于原发性无功能和急性排斥反应的诊断。引入额外的免疫抑制剂引发了几项大型临床试验。然而，环孢素仍然是这些药物必须与之比较的金标准。
