Puri Vichin, Eason James
Methodist/University of Tennessee Transplant Institute, 1211 Union Ave. Suite 340, Memphis, TN 38104 USA.
Curr Transplant Rep. 2015;2(4):297-302. doi: 10.1007/s40472-015-0077-2. Epub 2015 Oct 6.
In 2014, simultaneous liver kidney transplants (SLK) accounted for 8.2 % of all liver transplants performed in the USA. Prior to introduction of the model of end stage liver disease (MELD) system, SLK accounted for 2.5 % in 2001 and only 1.7 % in 1990. Transplant centers have struggled to balance the moral and ethical aspects of SLK in the setting of organ scarcity with an algorithm that best qualifies patients for such treatment options. Few centers have even ventured into DCD territory for SLK. Advancement in immunosuppression protocols and treatment of HCV and HIV have impacted SLK over the years. Simulation modeling has allowed us to analyze the future impact of our decisions that are made today. All of these advancements have given, and will continue to give new perspectives to SLK. The purpose of this review article is to highlight these advances and bring to light the studies that have made this transplant option successful.
2014年，肝肾联合移植（SLK）占美国所有肝脏移植手术的8.2%。在终末期肝病模型（MELD）系统引入之前，2001年肝肾联合移植占比为2.5%，1990年时仅为1.7%。在器官短缺的情况下，移植中心一直在努力通过一种能使患者最符合此类治疗选择的算法，来平衡肝肾联合移植在道德伦理方面的问题。很少有中心涉足肝肾联合移植的脑死亡后器官捐献（DCD）领域。多年来，免疫抑制方案以及丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）治疗方面的进展对肝肾联合移植产生了影响。模拟建模使我们能够分析当下所做决策对未来的影响。所有这些进展已经并将继续为肝肾联合移植带来新的视角。这篇综述文章的目的是突出这些进展，并揭示使这种移植选择取得成功的研究。
