朝着单中心每年超过400例肝移植的目标迈进。
Toward more than 400 liver transplantations a year at a single center.
作者信息
Moon D B, Lee S G, Hwang S, Kim K H, Ahn C S, Ha T Y, Song G W, Jung D H, Park G C, Namkoong J M, Park H W, Park Y H, Park C S
机构信息
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
出版信息
Transplant Proc. 2013 Jun;45(5):1937-41. doi: 10.1016/j.transproceed.2012.12.015.
BACKGROUND
For the first time at Asan Medical Center (AMC) we performed more than 400 liver transplantations (LTs) per year in 2011, despite same number of living donor liver transplantations (LDLTs).
METHODS
Our OLT program was started in 1992, but not activated well due to the scarcity of deceased donor organs. Since adult LDLTs using a left lobe and then a right lobe were successfully performed in 1997, we have developed several innovative techniques and approaches for adult LDLT, for example, modified right-lobe graft reconstructing middle hepatic branches in 1998, dual graft LDLT using 2 left lobes in 2000; new criteria for hepatocellular carcinoma (HCC); as well as ABO-incompatible LDLT, the first in the world. As a result, the number of LDLTs has increased rapidly but reached a plateau recently. Nationwide efforts to promote deceased donation increased the number of deceased donor liver transplantation (DDLT).
RESULTS
We have performed 317 LDLTs per year in 2010 and 2011, respectively. The number of LTs reached 403 in 2011. This large number was possible due to a remarkable increase of DDLTs from 50 in 2010 to 86 in 2011. Seventy-nine patients (68.1%) among 116 patients (28.8%) required an urgent LT receiving a DDLT. LT for HCC or ABO-mismatch comprised 50.3% (n = 150) or 8.7% (n = 35), respectively. In-hospital mortality rate in 2011 was 4.7%.
CONCLUSIONS
The increased LTs number at AMC was aided by the nationwide campaign.
背景
2011年，在峨山医疗中心（AMC），我们首次实现每年进行400多例肝移植手术（LTs），尽管活体肝移植（LDLTs）数量相同。
方法
我们的肝移植项目始于1992年，但由于已故供体器官稀缺，未能良好启动。自1997年成功进行了使用左叶然后右叶的成人活体肝移植后，我们开发了多种成人活体肝移植的创新技术和方法，例如，1998年改良右叶移植重建肝中支，2000年使用2个左叶的双移植活体肝移植；肝细胞癌（HCC）的新标准；以及世界首例ABO血型不相容活体肝移植。结果，活体肝移植数量迅速增加，但最近达到了平稳状态。全国范围内促进已故捐赠的努力增加了已故供体肝移植（DDLT）的数量。
结果
2010年和2011年我们分别每年进行317例活体肝移植。2011年肝移植数量达到403例。这个庞大的数字得益于已故供体肝移植从2010年的50例显著增加到2011年的86例。116例患者（占28.8%）中有79例（占68.1%）需要紧急肝移植，接受了已故供体肝移植。因肝细胞癌或ABO血型不匹配进行的肝移植分别占50.3%（n = 150）或8.7%（n = 35）。2011年的院内死亡率为4.7%。
结论
全国性运动有助于峨山医疗中心肝移植数量的增加。
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