Lee David D, Croome Kristopher P, Perry Dana K, Burns Justin M, Nguyen Justin H, Keaveny Andrew P, Taner C Burcin
Clin Transpl. 2014:83-90.
Over the sixteen year history of liver transplantation (LT) at Mayo Clinic in Jacksonville, Florida (MCF), we have maintained a practice devoted to excellence in pre- and post-LT management for patients suffering from end stage liver disease. With an emphasis on quality, MCF has made several adjustments with the goal of better utilizing marginal grafts for both successful post-transplant outcomes and minimizing waitlist mortality. This systematic approach is most exemplified in our experience with donation after cardiac death (DCD) liver allografts. Understanding the events during procurement has been critical to reducing the complications associated with donor warm ischemia time that are unique to DCD allografts. Better matching of donors to recipients has helped identify patients who are safe to receive more marginal grafts with successful patient and graft survival. Recognizing the spectrum of degree of sickness in patients undergoing LT, we implemented a multidisciplinary approach that allows for the avoidance of the intensive care unit after LT. In these ways, MCF continues to distinguish itself as an innovator in the field of transplantation for the benefit of continued better care for our patients suffering from end stage liver disease.
在佛罗里达州杰克逊维尔市梅奥诊所（MCF）开展肝移植（LT）的16年历史中，我们一直致力于为终末期肝病患者提供卓越的肝移植术前和术后管理。以质量为重点，MCF进行了多项调整，目标是更好地利用边缘供肝，以实现成功的移植后效果，并将等待名单上的死亡率降至最低。这种系统方法在我们使用心脏死亡后捐赠（DCD）肝脏同种异体移植物的经验中得到了最充分的体现。了解获取过程中的事件对于减少与DCD同种异体移植物特有的供体热缺血时间相关的并发症至关重要。供体与受体的更好匹配有助于识别那些接受边缘性更强的移植物且患者和移植物存活成功的安全患者。认识到接受肝移植患者的疾病严重程度范围，我们实施了多学科方法，使患者在肝移植后无需进入重症监护病房。通过这些方式，MCF继续在移植领域展现创新能力，以便为我们的终末期肝病患者持续提供更好的护理。
