Nugroho Adianto, Kim Ok-Kyung, Lee Kwang-Woong, Song Sanghee, Kim Hyeyoung, Hong Suk Kyun, Yoon Kyung Chul, Kim Hyo-Sin, Choi YoungRok, Lee Hae Won, Yi Nam-Joon, Suh Kyung-Suk
Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Organ Transplant Center, Seoul National University Hospital, Seoul, South Korea.
Liver Transpl. 2017 May;23(5):614-624. doi: 10.1002/lt.24762.
The process of evaluating potential donors in liver transplantation is important to ensure donor safety and provide optimal recipient outcomes. However, there has been no report about donor exclusion rates and reasons for such exclusion in Korea. In this study, we aimed to elucidate the outcomes of potential living liver donor evaluation in a major living donor liver transplantation center. From July 2011 to June 2015, prospectively collected data of 726 potential donors for 588 matched recipients were subsequently evaluated. Among 726 potential donors, 374 potential donors (51.5%) finally reached donation; 352 potential donors (48.5%) were excluded for various reasons. Donor reasons were 29.8%, including medical problems, withdrawal of consent, graft volume issues, and identification of a better suitable donor. Recipient reasons were 20.7%, including recipient death or recovery, allocation to deceased donor, and progressions of hepatocellular carcinoma. A total of 38 (5.2%) potential donors had a fatty liver. Among them, 15 (39.5%) potential donors tried short-term weight reduction and eventually were able to donate. In conclusion, the main reasons for donor exclusion were medical problems and withdrawal of consent. Therefore, thorough medical screening and careful examination for donor voluntarism are important in the donor evaluation process. Liver Transplantation 23 614-624 2017 AASLD.
在肝移植中评估潜在供体的过程对于确保供体安全和为受体提供最佳预后非常重要。然而，韩国尚无关于供体排除率及排除原因的报道。在本研究中，我们旨在阐明一家大型活体供肝移植中心潜在活体肝供体评估的结果。2011年7月至2015年6月，对前瞻性收集的726名潜在供体与588名匹配受体的数据进行了后续评估。在726名潜在供体中，374名潜在供体（51.5%）最终完成捐赠；352名潜在供体（48.5%）因各种原因被排除。供体方面的原因占29.8%，包括医疗问题、撤回同意、移植物体积问题以及发现更合适的供体。受体方面的原因占20.7%，包括受体死亡或康复、分配至 deceased donor（此处原文有误，可能是“分配至 deceased donor liver transplantation”，即分配至尸体供肝移植）以及肝细胞癌进展。共有38名（5.2%）潜在供体存在脂肪肝。其中，15名（39.5%）潜在供体尝试短期减重并最终得以捐赠。总之，供体被排除的主要原因是医疗问题和撤回同意。因此，在供体评估过程中，进行全面的医学筛查和仔细检查供体的自愿性非常重要。《肝脏移植》23 614 - 624 2017美国肝脏病研究协会
