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[活体肝供体:适应证与技术要点]

[Living liver donor: indications and technical aspects].

作者信息

Nadalin S, Capobianco I, Königsrainer I, Harder B, Königsrainer A

机构信息

Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland.

出版信息

Chirurg. 2015 Jun;86(6):609-21; quiz 622. doi: 10.1007/s00104-015-0017-9.

Abstract

Living donor liver transplantation (LDLT) nowadays represents an important and safe alternative to conventional deceased donor liver transplantation (DDLT). A major concern related to the LDLT procedure is still represented by donor safety because a serious operation not without risks must be carried out on a healthy individual. In the present review of the indications for LDLT the technical concepts of donor surgery, criteria for donor selection and evaluation and morbidity and mortality results related to the procedure are presented. In general, the indications for LDLT are almost the same as for DDLT. The donor hepatectomy (right, left or left lateral) is presented in five main phases. The reported morbidity rates vary between 10 % and 60 % and are strongly related to the experience of the transplant center. The currently reported postoperative mortality rates for left and right hepatectomy are 0.1 % and 0.5 %, respectively. The results of LDLT are similar if not even better than those for DDLT depending on the specific indications.

摘要

如今,活体肝移植(LDLT)是传统尸体供肝肝移植(DDLT)的一种重要且安全的替代方案。与活体肝移植手术相关的一个主要问题仍然是供体安全,因为必须在健康个体身上进行有风险的重大手术。在本次关于活体肝移植适应症的综述中,介绍了供体手术的技术概念、供体选择和评估标准以及与该手术相关的发病率和死亡率结果。一般来说,活体肝移植的适应症与尸体供肝肝移植几乎相同。供肝切除术(右半肝、左半肝或左外叶)分为五个主要阶段。报告的发病率在10%至60%之间,并且与移植中心的经验密切相关。目前报告的左半肝和右半肝切除术后死亡率分别为0.1%和0.5%。根据具体适应症,活体肝移植的结果即使不比尸体供肝肝移植更好,也与之相似。

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