Kiuchi Tetsuya
Division of Transplantation Surgery, Department of Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, Tsurumai-cho, Showa-ku, Nagoya, Japan.
Transplantation. 2008 Oct 27;86(8):1026-7. doi: 10.1097/TP.0b013e31818774c3.
The barriers to the success of early patient and graft survival after liver transplantation have been progressively resolved. Now, strategies to provide this life-saving technique in quality-oriented and cost-effective manner in the long term are emerging as the next central issues. Beyond the first year of transplant, the risk of surgical complications and infection is reduced, and the incidence of rejection falls precipitously. Instead, attention is turning to minimization of recurrence of original diseases including malignancy and de novo diseases. Attempt to minimize toxicity of immunosuppressive agents and their potential negative impact on metabolic and renal function is another central issue. This is important especially in pediatric patients who are expected to survive at least more than decades after transplantation.
肝移植术后早期患者和移植物存活成功的障碍已逐步得到解决。现在，以质量为导向且具有成本效益的方式长期提供这种挽救生命技术的策略正成为下一个核心问题。移植一年后，手术并发症和感染的风险降低，排斥反应的发生率急剧下降。相反，注意力正转向将包括恶性肿瘤和新发疾病在内的原发病复发降至最低。尽量减少免疫抑制剂的毒性及其对代谢和肾功能的潜在负面影响是另一个核心问题。这在预计移植后至少能存活数十年的儿科患者中尤为重要。
