美国的活体供肝肝移植
Living donor liver transplantation in the USA.
作者信息
Kim Peter T W, Testa Giuliano
机构信息
Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, USA.
出版信息
Hepatobiliary Surg Nutr. 2016 Apr;5(2):133-40. doi: 10.3978/j.issn.2304-3881.2015.06.01.
Abstract
Living donor liver transplant (LDLT) accounts for a small volume of the transplants in the USA. Due to the current liver allocation system based on the model for end-stage liver disease (MELD), LDLT has a unique role in providing life-saving transplantation for patients with low MELD scores and significant complications from portal hypertension, as well as select patients with hepatocellular carcinoma (HCC). Donor safety is paramount and has been a topic of much discussion in the transplant community as well as the general media. The donor risk appears to be low overall, with a favorable long-term quality of life. The latest trend has been a gradual shift from right-lobe grafts to left-lobe grafts to reduce donor risk, provided that the left lobe can provide adequate liver volume for the recipient.
摘要
活体供肝移植（LDLT）在美国的肝移植总量中占比很小。由于目前基于终末期肝病模型（MELD）的肝脏分配系统，LDLT在为MELD评分低且门静脉高压并发症严重的患者以及部分肝细胞癌（HCC）患者提供挽救生命的移植方面具有独特作用。供体安全至关重要，一直是移植界以及大众媒体热议的话题。总体而言，供体风险似乎较低，长期生活质量良好。最新趋势是逐渐从右叶供肝移植转向左叶供肝移植以降低供体风险，前提是左叶能够为受体提供足够的肝脏体积。
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