Cuenca Alex G, Kim Heung Bae, Vakili Khashayar
Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Fegan 3, Boston 02115, MA.
Department of Surgery, Pediatric Transplant Center, Boston Children's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Semin Pediatr Surg. 2017 Aug;26(4):217-223. doi: 10.1053/j.sempedsurg.2017.07.014. Epub 2017 Jul 26.
Considerable strides have been made over the last several decades toward improving outcomes in pediatric liver transplantation. Refinements in surgical technique has allowed for the use of living donor and deceased donor split-liver grafts, thus expanding the pool of available organs and reducing waitlist mortality. The use of a multidisciplinary team continues to be paramount in the care of the transplant recipient. With improvements in overall graft and survival, indications for liver transplantation have also broadened. Currently, pediatric transplant patients have a 5-year survival of over 85%. Long-term morbidity is mainly associated with complications from immunosuppression and chronic rejection. Here we review indications for liver transplantation in children, surgical considerations, post-operative complications, and long-term outcomes.
在过去几十年里，小儿肝移植在改善治疗效果方面取得了长足的进步。手术技术的改进使得活体供肝和尸体供肝劈离式肝移植得以应用，从而扩大了可用器官库并降低了等待名单上的死亡率。多学科团队的使用在移植受者的护理中仍然至关重要。随着整体移植物和生存率的提高，肝移植的适应证也有所拓宽。目前，小儿移植患者的5年生存率超过85%。长期发病率主要与免疫抑制和慢性排斥反应的并发症有关。在此，我们综述儿童肝移植的适应证、手术注意事项、术后并发症及长期预后。
