Brige Pauline, Hery Géraldine, Chopinet Sophie, Palen Anaïs, Azoulay Daniel, Gregoire Emilie
Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research, Marseille, France.
Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research; Aix-Marseille University, Department of Pediatric Surgery and Liver Transplantation, Hôpital de la Timone Enfant, Marseille, France.
J Gastrointestin Liver Dis. 2018 Jun;27(2):169-178. doi: 10.15403/jgld.2014.1121.272.mor.
The main restriction in the development of adult-adult Living Donor Liver Transplantation (LDLT) is the risk of morbidity and mortality for donors, which raises ethical questions. The objectives of this study are to review published studies dealing with morbidity and mortality in LDLT and to identify the proposed management and strategies for preventing donor mortality and morbidity in LDLT.
The Medline database was searched from 2000 to 2017 using the MeSH terms "liver transplantation" and "morbidity" or "mortality" in combination with keywords "living donor liver transplantation".
Among the 382 articles obtained, 43 articles were relevant for morbidity, 15 for mortality and 6 for both morbidity and mortality. Twenty-three papers reported donor deaths. The major cause of death was sepsis (30%). Morbidity ranged from 10% to 78.3% depending on the studies.
The living donors' morbidity and mortality is high, currently representing the main restriction in the development of LDLT. Some promising techniques, such as the donor portal vein flow modulation could lead to the further development of LDLT.
成人对成人活体肝移植（LDLT）发展的主要限制因素是供体发生发病和死亡的风险，这引发了伦理问题。本研究的目的是回顾已发表的关于LDLT中发病和死亡情况的研究，并确定所提出的用于预防LDLT供体死亡和发病的管理方法及策略。
使用医学主题词“肝移植”以及“发病”或“死亡”并结合关键词“活体肝移植”，对2000年至2017年的Medline数据库进行检索。
在获得的382篇文章中，43篇与发病情况相关，15篇与死亡情况相关，6篇与发病和死亡情况均相关。23篇论文报告了供体死亡情况。主要死亡原因是脓毒症（30%）。根据不同研究，发病率在10%至78.3%之间。
活体供体的发病和死亡率较高，目前是LDLT发展的主要限制因素。一些有前景的技术，如供体门静脉血流调节，可能会推动LDLT的进一步发展。
