Liver Transplant Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, Taiwan 833.
Nat Rev Gastroenterol Hepatol. 2013 Dec;10(12):746-51. doi: 10.1038/nrgastro.2013.194. Epub 2013 Oct 8.
The success of liver transplantation worldwide has brought increased demand for the liver graft. Western and Asian countries have coped differently with the problems of the shortages in organ donation. In the West, efforts have focused on promoting deceased donor organ donation, whereas in Asia the focus has been on living donor liver transplantation (LDLT), as this procedure is more acceptable in most Asian cultures. LDLT, which was initially devised for paediatric liver transplant patients, has evolved from using a left lobe graft to a right lobe graft for an adult recipient. To widen the donor pool, dual grafts for a single recipient have been used in LDLT, and donors with hepatitis B core antibody positivity have been accepted, as well as ABO incompatible donors and recipients. The great advances in the field of LDLT have been dictated by the needs and the norms of Asian society. In this Perspectives article, we outline the reasons why LDLT flourishes in Asia.
全球肝移植的成功带来了对肝移植物的需求增加。西方和亚洲国家以不同的方式应对器官捐献短缺的问题。在西方，努力的重点是促进已故供体器官捐献，而在亚洲，重点则是活体肝移植（LDLT），因为这种手术在大多数亚洲文化中更能被接受。LDLT 最初是为儿科肝移植患者设计的，已经从使用左叶移植物发展为使用右叶移植物为成年受者进行移植。为了扩大供体库，在 LDLT 中使用了双移植物供一个受者，并接受了乙型肝炎核心抗体阳性的供者，以及 ABO 不相容的供者和受者。LDLT 领域的巨大进步是由亚洲社会的需求和规范决定的。在这篇观点文章中，我们概述了 LDLT 在亚洲蓬勃发展的原因。
