Department of Pediatrics, Neonatal and Pediatric Intensive Care Unit, APHP-Bicêtre Hospital, Paris 11-Sud University, 94275 Le Kremlin-Bicêtre, France.
Expert Rev Gastroenterol Hepatol. 2013 Sep;7(7):629-41. doi: 10.1586/17474124.2013.832486.
Pediatric liver transplantation (LT) is one of the most successful solid organ transplants with long-term survival more than 80%. Many aspects have contributed to improve survival, especially advancements in pre-, peri- and post-transplant management. The development of new surgical techniques, such as split-LT and the introduction of living related LT, has extended LT to small infants. Progress in the last 30 years has also been characterized by the introduction of calcineurin inhibitors. One problem remains the lack of donors. Donation after cardiac death offers a new possibility to increase the pool of potential donors. In children with acute liver failure, increasing interest has centered on the possibility of providing temporary liver support based on extracorporeal devices or hepatocyte transplantation. Similarly, hepatocyte transplantation offers new perspective in children with metabolic failure. As long-term survival increases, attention has now focused on the quality of life achieved by children undergoing LT.
小儿肝移植（LT）是最成功的实体器官移植之一，长期存活率超过 80%。许多方面都有助于提高存活率，特别是在移植前、移植中和移植后管理方面的进展。新的外科技术的发展，如劈离式 LT 和活体亲属 LT 的引入，已经将 LT 扩展到了小婴儿。在过去 30 年的发展过程中，钙调神经磷酸酶抑制剂的引入也是一个特点。一个问题仍然是供体的缺乏。心脏死亡后的捐献为增加潜在供体池提供了新的可能性。在急性肝衰竭的儿童中，人们越来越关注基于体外设备或肝细胞移植提供临时肝脏支持的可能性。同样，肝细胞移植为代谢衰竭的儿童提供了新的视角。随着长期存活率的提高，人们现在开始关注接受 LT 的儿童的生活质量。
