Lala Sanjay Govind, Britz Russell, Botha Jean, Loveland Jerome
Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
S Afr Med J. 2014 Oct 24;104(11):829-832. doi: 10.7196/samj.8624.
Paediatric liver transplantation (PLT) is the only therapeutic option for many children with end-stage chronic liver disease or irreversible fulminant hepatic failure and is routinely considered as a therapy by paediatric gastroenterologists and surgeons working in developed countries. In South Africa (SA), a PLT programme is available at Red Cross War Memorial Children's Hospital in Cape Town since November 1991, and another has rapidly developed at the Wits Donald Gordon Medical Centre in Johannesburg over the past decade. However, for most children with progressive chronic liver disease who are reliant on the services provided at public health facilities in SA, PLT is not an option because of a lack of resources in a mismanaged public health system. This article briefly outlines the services offered at Chris Hani Baragwanath Academic Hospital - which is typical of public health facilities in SA - and proposes that resources be allocated to establish an innovative, nationally funded centre that would enable greater numbers of children access to a PLT programme.
小儿肝移植（PLT）是许多终末期慢性肝病或不可逆暴发性肝衰竭患儿的唯一治疗选择，在发达国家，小儿胃肠病学家和外科医生通常将其视为一种治疗方法。自1991年11月以来，南非（SA）开普敦的红十字战争纪念儿童医院设有小儿肝移植项目，在过去十年中，约翰内斯堡的威特斯唐纳德·戈登医疗中心也迅速发展了另一个项目。然而，对于大多数依赖南非公共卫生机构提供服务的进行性慢性肝病患儿来说，由于管理不善的公共卫生系统缺乏资源，小儿肝移植并非选择。本文简要概述了克里斯·哈尼·巴拉干纳特学术医院提供的服务——这是南非公共卫生机构的典型代表——并提议分配资源建立一个由国家资助的创新中心，使更多儿童能够接受小儿肝移植项目。
