Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan.
Division of HPB Surgery, Department of Surgery, National University of Singapore, Singapore.
Int J Surg. 2020 Oct;82S:4-8. doi: 10.1016/j.ijsu.2020.05.071. Epub 2020 Jun 11.
In spite of early adoption of the brain death legislation, and all efforts at promoting deceased donation, various social, economic and cultural factors have acted as road blocks to the furthering of deceased donor liver transplantation (DDLT) in most Asian societies. On the other hand, Asian liver transplant centers have been the pioneers, innovators, and technical advancement catalysts for the world to follow, especially with regards to living donor liver transplantation (LDLT). With some high volume centers performing more than 200 LDLTs a year with good outcomes in the donor and recipient, techniques to expand the living donor pool have also been adopted like ABO-incompatible, paired exchange and dual lobe living donor liver transplants. Although large multicenter, and registry data as regards safety and outcomes of minimally invasive donor hepatectomy are awaited, expert centers have pioneered, and now regularly perform purely laparoscopic and robotic living donor hepatectomies, especially in Korea.
尽管亚洲各国很早就采用了脑死亡立法，并为促进器官捐献做出了各种努力，但各种社会、经济和文化因素仍是阻碍大多数亚洲社会开展器官捐献肝脏移植（DDLT）的绊脚石。另一方面，亚洲肝脏移植中心一直是世界各国的先驱、创新者和技术进步的推动者，尤其是在活体肝移植（LDLT）方面。一些大的肝脏移植中心每年进行 200 多例 LDLT，供体和受体的效果良好，因此也采用了扩大活体供体库的技术，如 ABO 不相容、配对交换和双叶活体供肝移植。尽管人们期待着有更多关于微创供肝切除术的安全性和结果的多中心和注册数据，但专家中心已经率先开展，并定期进行纯腹腔镜和机器人活体供肝切除术，特别是在韩国。
