Tamura Sumihito, Sugawara Yasuhiko, Kaneko Junichi, Togashi Junichi, Matsui Yuichi, Yamashiki Noriyo, Kokudo Norihiro, Makuuchi Masatoshi
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
World J Gastroenterol. 2008 Sep 7;14(33):5105-9. doi: 10.3748/wjg.14.5105.
End-stage liver disease, due to cholestatic liver diseases with an autoimmune background such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), is considered a good indication for liver transplantation. Excellent overall patient and graft outcomes, based mostly on the experience from deceased donor liver transplantation (DDLT), have been reported. Due to the limited number of organ donations from deceased donors in most Asian countries, living donor liver transplantation (LDLT) is the mainstream treatment for end-stage liver disease, including that resulting from PBC and PSC. Although the initial experiences with LDLT for PBC and PSC seem satisfactory or comparable to that with DDLT, some aspects, including the timing of transplantation, the risk of recurrent disease, and its long-term clinical implications, require further evaluation. Whether or not the long-term outcomes of LDLT from a biologically related donor are equivalent to that of DDLT requires further observations. The clinical course following LDLT may be affected by the genetic background shared between the recipient and the living related donor.
终末期肝病，如由自身免疫性背景的胆汁淤积性肝病（如原发性胆汁性肝硬化（PBC）和原发性硬化性胆管炎（PSC））引起的，被认为是肝移植的良好指征。据报道，基于尸体供肝肝移植（DDLT）的经验，患者和移植物的总体预后良好。由于大多数亚洲国家尸体供体的器官捐赠数量有限，活体供肝肝移植（LDLT）是终末期肝病（包括由PBC和PSC导致的终末期肝病）的主流治疗方法。尽管LDLT治疗PBC和PSC的初步经验似乎令人满意或与DDLT相当，但包括移植时机、疾病复发风险及其长期临床意义等一些方面仍需要进一步评估。来自生物学相关供体的LDLT的长期预后是否等同于DDLT需要进一步观察。LDLT后的临床病程可能会受到受体与活体亲属供体之间共享的遗传背景的影响。
