Adam Rene, Hoti Emir
AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France.
Semin Liver Dis. 2009 Feb;29(1):3-18. doi: 10.1055/s-0029-1192052. Epub 2009 Feb 23.
Over the years, an improving liver transplant (LT) survival rate (1- and 5-year survival of 83% and 75%, respectively) has been instrumental in establishing transplant surgery as a durable therapy for all forms of end-stage liver disease and for some malignant conditions. The success of such treatment has resulted in a progressively increasing demand for liver transplantation. However, at the same time the availability of donor organs has diminished, resulting in the number of potential recipients for liver transplantation exceeding organ supply. Several strategies have been explored with the aim to increase access to liver transplantation, including: obtaining organs from non-heart-beating donors and live donors, and splitting and using livers from expanded donor criteria. This article discusses the utility of the mentioned techniques along with other strategies (e.g., Model for End-Stage Liver Disease [MELD] score), as well as the evolution of indications, contraindications, and postoperative care.
多年来，肝移植（LT）生存率的提高（1年和5年生存率分别为83%和75%）有助于确立移植手术作为治疗各种终末期肝病和某些恶性疾病的持久疗法。这种治疗的成功导致对肝移植的需求逐渐增加。然而，与此同时，供体器官的可获得性减少，导致肝移植潜在受者的数量超过了器官供应。人们探索了几种旨在增加肝移植可及性的策略，包括：从非心脏跳动供体和活体供体获取器官，以及分割和使用扩大标准供体的肝脏。本文讨论了上述技术以及其他策略（如终末期肝病模型[MELD]评分）的效用，以及适应证、禁忌证和术后护理的演变。
