Schwartz Jason J, Hutson William R, Gayowski Timothy J, Sorensen John B
Department of Surgery, University of Utah, Salt Lake City, 30 N 1900 E, Salt Lake City, UT 84132, USA.
Transplantation. 2009 Aug 15;88(3):295-8. doi: 10.1097/TP.0b013e3181adc9e5.
Liver transplantation for cholangiocarcinoma (CCA) remains a controversial subject. More than 15 years after, a novel protocol combining neoadjuvant chemoradiation and orthotopic liver transplantation was first used in patients with unresectable hilar CCAs, these methods have yet to reach broad application. Results have confirmed that this approach leads to significantly lower recurrence rates and higher long-term survival rates than other existing treatment modalities. Despite this, protocols to treat patients with CCA are not widespread, and are available at only a handful of transplant programs. At these centers, treatment success may ultimately hinge on regional model for end-stage liver disease scores and waiting time for transplant. While acknowledging these factors as well as a severe organ shortage, it is important that the transplant community not overlook a potentially effective form of therapy for a previously untreatable disease.
胆管癌（CCA）的肝移植仍然是一个有争议的话题。15年多过去了，一种将新辅助放化疗与原位肝移植相结合的新方案首次用于无法切除的肝门部CCA患者，但这些方法尚未得到广泛应用。结果证实，与其他现有治疗方式相比，这种方法能显著降低复发率并提高长期生存率。尽管如此，治疗CCA患者的方案并不普遍，只有少数移植项目可以提供。在这些中心，治疗成功可能最终取决于终末期肝病评分系统和移植等待时间。在认识到这些因素以及严重的器官短缺问题的同时，移植界不应忽视一种可能对以前无法治疗的疾病有效的治疗方式，这一点很重要。
