影响小儿肝移植患者及移植物预后的早期和晚期因素：ESPGHAN单主题会议总结

Early and Late Factors Impacting Patient and Graft Outcome in Pediatric Liver Transplantation: Summary of an ESPGHAN Monothematic Conference.

作者信息

McLin Valérie A, Allen Upton, Boyer Olivia, Bucuvalas John, Colledan Michele, Cuturi Maria-Cristina, d'Antiga Lorenzo, Debray Dominique, Dezsofi Antal, Goyet Jean de Ville de, Dhawan Anil, Durmaz Ozlem, Falk Christine, Feng Sandy, Fischler Björn, Franchi-Abella Stéphanie, Frauca Esteban, Ganschow Rainer, Gottschalk Stephen, Hadzic Nedim, Hierro Loreto, Horslen Simon, Hubscher Stefan, Karam Vincent, Kelly Deirdre, Maecker-Kolhoff Britta, Mazariegos George, McKiernan Patrick, Melk Anette, Nobili Valerio, Ozgenç Funda, Reding Raymond, Sciveres Marco, Sharif Khalid, Socha Piotr, Toso Christian, Vajro Pietro, Verma Anita, Wildhaber Barbara E, Baumann Ulrich

机构信息

*Swiss Center for Liver Disease in Children, University Hospitals Geneva, Geneva, Switzerland †Division of Infectious Diseases and the Transplant and Regenerative Medicine Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada ‡Pediatric Nephrology, Imagine Institute, Necker-Enfants Malades Hospital, APHP, Paris Descartes University-Sorbonne Paris Cité, Paris, France §Pediatric Liver Care Center, Cincinnati Children's Hospital, Cincinnati, OH ||Department of Surgery, Ospedale Papa Giovanni XXIII, Bergamo, Italy ¶Faculté de Médecine, University de Nantes, Nantes, France #Pediatric Hepatology, Gastroenterology and Transplantation, Ospedale Papa Giovanni XXIII, Bergamo, Italy **Pediatric Hepatology Unit, Necker Enfants Malades Hospital, Paris, France ††First Department of Pediatrics, Semmelweis University, Budapest, Hungary ‡‡University Tor Vergata, Rome, Italy §§Pediatric Liver GI and Nutrition Centre, King's College Hospital, London, UK ||||Faculty of Medicine, Istanbul University, Istanbul, Turkey ¶¶Institute of Transplant Immunology, FIB-Tx, Hannover Medical School, Germany ##Abdominal Transplant Surgery, University of California San Francisco, San Francisco, CA ***Department of Pediatrics, Karolinska University Hospital, CLINTEC Karolinska Institutet, Stockholm, Sweden †††Pediatric Radiology Department, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud- Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France ‡‡‡Pediatric Hepatology and Liver Transplantation, Hospital Universitario Infantil La Paz, Madrid, Spain §§§Department of Pediatrics, University Children's Hospital Bonn, Bonn, Germany ||||||Center for Cell and Gene Therapy and Texas Children's Cancer Center, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, TX ¶¶¶Pediatric Liver GI and Nutrition Centre, King's College, London, UK ###Seattle Children's Hospital and University of Washington, Seattle, WA ****School of Cancer Sciences ††††Department of Cellular Pathology, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK ‡‡‡‡The European Transplant Registry, APHP Paul Brousse Hospital, Villejuif, France §§§§Liver Unit, Birmingham Children's Hospital, Birmingham, UK ||||||||Department of Pediatric Hematology/Oncology and Integrated Research and Treatment Center for Transplantation, Hannover Medical School, Germany ¶¶¶¶Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh, Pittsburgh, PA ####Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Pediatrics, University of Salerno, Baronissi, Italy *****Bambino Gesu Children's Hospital, Rome, Italy †††††Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Ege University, Izmir, Turkey ‡‡‡‡‡Pediatric Surgery and Transplantation Unit, Cliniques Universitaires de Saint-Luc, Université Catholique de Louvain, Brussels, Belgium §§§§§ISMETT, University of Pittsburgh Medical Center, Palermo, Italy ||||||||||The Children's Memorial Health Institute, Warsaw, Poland ¶¶¶¶¶Divisions of Abdominal and Transplant Surgery, Faculty of Medicine and University Hospitals Geneva, Geneva, Switzerland #####University of Salerno, Baronissi, Italy ******King's College Hospital, Institute of Liver Studies, London, UK ††††††Department for Pediatric Kidney, Liver and Metabolic Disease, Division of Pediatric Gastroenterology and Hepatology, Hannover Medical School, Hannover, Germany.

出版信息

J Pediatr Gastroenterol Nutr. 2017 Sep;65(3):e53-e59. doi: 10.1097/MPG.0000000000001564.

DOI:10.1097/MPG.0000000000001564

PMID:28319600

Abstract

As pediatric liver transplantation comes of age, experts gathered to discuss current paradigms and define gaps in knowledge warranting research to further improve patient and graft outcomes. Identified areas ripe for collaborative research include understanding the molecular and cellular mechanisms of tolerance and the role of donor-specific antibodies, considering ways to expand donor pool, minimizing long-term side effects of immunosuppression, and fine-tuning surgical techniques to minimize biliary and vascular complications.

摘要

随着小儿肝移植逐渐成熟，专家们齐聚一堂，讨论当前的模式，并明确知识空白，这些空白需要通过研究来进一步改善患者和移植物的预后。确定适合开展合作研究的领域包括了解耐受的分子和细胞机制以及供体特异性抗体的作用，考虑扩大供体库的方法，将免疫抑制的长期副作用降至最低，以及优化手术技术以减少胆道和血管并发症。