Emory Transplant Center, Emory University, Atlanta, GA 30322, USA.
Transplant Rev (Orlando). 2011 Oct;25(4):167-77. doi: 10.1016/j.trre.2011.04.002. Epub 2011 Jul 30.
The long-term shortage of livers available for transplantation has spurred the development of many strategies to bolster the donor organ supply. One particularly innovative strategy is domino liver transplantation in which a select group of liver transplant recipients can donate their explanted native livers for use as liver grafts in other patients. Several hereditary metabolic diseases (such as familial amyloid polyneuropathy, maple syrup urine disease, and familial hypercholesterolemia) are caused by aberrant or deficient protein production in the liver, and these conditions can be cured with an orthotopic liver transplant. Although their native livers eventually caused severe systemic disease in these patients, these livers are otherwise structurally and functionally normal, and they have been used successfully in domino liver transplants for the past 15 years. This article will review the indications for donating or receiving a domino liver transplant, the surgical techniques necessary to perform these transplants, as well as the recently revealed long-term outcomes and risks of domino transplantation.
长期以来，可供移植的肝脏短缺，这促使人们开发了许多策略来增加供体器官的供应。其中一个特别创新的策略是多米诺肝移植，在这种移植中，选择一组肝移植受者可以捐献他们已移植的原肝，用于其他患者的肝移植。一些遗传性代谢疾病（如家族性淀粉样多神经病、枫糖尿症和家族性高胆固醇血症）是由肝脏中异常或缺乏蛋白质产生引起的，这些疾病可以通过原位肝移植治愈。尽管这些患者的原肝最终导致严重的全身疾病，但这些肝脏在结构和功能上是正常的，并且在过去 15 年中已成功用于多米诺肝移植。本文将回顾进行多米诺肝移植捐献或接受的适应证、进行这些移植所需的手术技术，以及最近揭示的多米诺移植的长期结果和风险。
