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肠道移植的现状与未来展望

Present status and future perspectives of intestinal transplantation.

作者信息

Pascher Andreas, Kohler Sven, Neuhaus Peter, Pratschke Johann

机构信息

Department of Visceral and Transplantation Surgery, Universitaetsmedizin Berlin - Charité, Berlin, Germany.

出版信息

Transpl Int. 2008 May;21(5):401-14. doi: 10.1111/j.1432-2277.2008.00637.x. Epub 2008 Feb 18.

Abstract

Intestinal transplantation (ITx) is the only definitive therapy for irreversible intestinal failure. Owing to the limited short- and long-term graft survival over the years, ITx has been a complementary treatment to home parenteral nutrition. However, the development of intestinal and multivisceral transplantation has been significant over the past 15-20 years owing to the progress in immunosuppressive therapy, refinement of surgical techniques, post-transplant care, intestinal immunology, and immunological as well as anti-infectious monitoring. The improvement of patient- and graft survival over the last few years together with data on the cost effectiveness of ITx, following 2 years after transplantation, may require a redefinition of the indication for ITx.

摘要

肠道移植(ITx)是不可逆性肠衰竭的唯一确定性治疗方法。由于多年来短期和长期移植物存活率有限,ITx一直是家庭肠外营养的补充治疗方法。然而,由于免疫抑制治疗的进展、手术技术的改进、移植后护理、肠道免疫学以及免疫和抗感染监测等方面的进步,在过去15至20年中,肠道和多脏器移植有了显著发展。过去几年患者和移植物存活率的提高以及移植后2年ITx成本效益的数据,可能需要重新定义ITx的适应症。

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