Black Cara K, Termanini Kareem M, Aguirre Oswaldo, Hawksworth Jason S, Sosin Michael
Georgetown University School of Medicine, Washington, DC, USA.
MedStar Georgetown University Hospital, MedStar Georgetown Transplant Institute, Washington, DC, USA.
Ann Transl Med. 2018 Oct;6(20):409. doi: 10.21037/atm.2018.09.68.
Solid organ transplantation (SOT) has emerged from an experimental approach in the 20 century to now being an established and practical definitive treatment option for patients with end-organ dysfunction. The evolution of SOT has seen the field progress rapidly over the past few decades with incorporation of a variety of solid organs-liver, kidney, pancreas, heart, and lung-into the donor pool. New advancements in surgical technique have allowed for more efficient and refined multi-organ procurements with minimal complications and decreased ischemic injury events. Additionally, immunosuppression therapy has also seen advancements with the expansion of immunosuppressive protocols to dampen the host immune response and improve short and long-term graft survival. However, the field of SOT faces new barriers, most importantly the expanding demand for SOT that is outpacing the current supply. Allocation protocols have been developed in an attempt to address these concerns. Other avenues for SOT are also being explored to increase the donor pool, including split-liver donor transplants, islet cell implantation for pancreas transplants, and xenotransplantation. The future of SOT is bright with exciting new research being explored to overcome current obstacles.
实体器官移植（SOT）已从20世纪的一种实验性方法发展成为如今针对终末期器官功能障碍患者的一种既定且实用的确定性治疗选择。在过去几十年里，随着肝脏、肾脏、胰腺、心脏和肺等多种实体器官被纳入供体库，SOT领域取得了迅速进展。手术技术的新进展使得更高效、精细的多器官获取成为可能，并发症最少，缺血性损伤事件减少。此外，免疫抑制疗法也随着免疫抑制方案的扩展而取得进展，以抑制宿主免疫反应并提高移植物的短期和长期存活率。然而，SOT领域面临新的障碍，最重要的是SOT需求不断增加，超过了当前的供应。为解决这些问题已制定了分配方案。还在探索SOT的其他途径以增加供体库，包括劈离式肝移植供体移植胰、胰岛细胞植入胰腺移植和异种移植。随着为克服当前障碍而探索的令人兴奋的新研究不断涌现，SOT的未来一片光明。
