Yang Xiaoli, Gong Junhua, Gong JianPing
Department of Hepatobiliary Surgery, Second Affiliated Hospital of Chongqing Medical College, Yuzhong District, Chongqing, China.
Ann Transplant. 2012 Dec 31;17(4):120-4. doi: 10.12659/aot.883702.
Living donor liver transplantation (LDLT) is a very successful procedure that develops liver resources in case of worldwide shortages. As the technology has developed so much in the past 2 decades, LDLT has the same good prognosis as DDLT. However, LDLT still has lots of ethical & technical problems. It causes great psychiatric, physical and psychosocial harm to donors. Also, it has some negative effects on society by providing a platform for organ trade. Therefore, there is much controversy about the social value of LDLT. After review of recent papers, we find much progress can be made in inspiring the public to become organ donors and creating donation model new to improve the consent rate for solid organ donation from deceased donors. That is the key strategy for increasing the liver supply. With this serious shortage of organs, liver donor transplantation still has its advantages, but we should not place all our hopes on LDLT to increase the liver supply. We all need to try our best to increase donor awareness and promote organ donor registration--when cadaver organs could meet the needs for liver transplantation, living donor liver transplants would not be necessary.
活体肝移植(LDLT)是一种非常成功的手术,在全球肝脏资源短缺的情况下拓展了肝脏来源。由于在过去20年里这项技术有了很大发展,活体肝移植与尸体肝移植(DDLT)有着同样良好的预后。然而,活体肝移植仍然存在许多伦理和技术问题。它会给供体带来巨大的精神、身体和社会心理伤害。此外,它还通过为器官交易提供平台而对社会产生一些负面影响。因此,关于活体肝移植的社会价值存在诸多争议。在查阅近期论文后,我们发现,在激励公众成为器官捐献者以及创建新的捐献模式以提高尸体器官捐献同意率方面可以取得很大进展。这是增加肝脏供应的关键策略。鉴于器官严重短缺,活体肝移植仍有其优势,但我们不应将增加肝脏供应的所有希望都寄托在活体肝移植上。我们都需要尽最大努力提高捐献者意识并促进器官捐献登记——当尸体器官能够满足肝移植需求时,活体肝移植就不再必要。