Tautenhahn H-M, Rauchfuß F, Ali Deeb A, Bauschke A, Settmacher U
Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
Research Programme "Else Kröner-Forschungskolleg AntiAge", Universitätsklinikum Jena, Jena, Deutschland.
Chirurg. 2020 Nov;91(11):926-933. doi: 10.1007/s00104-020-01268-7.
Liver transplantation has become established as a standard procedure in the treatment of end-stage liver diseases. Despite intense efforts by all parties involved up to the amendment of the German Transplantation Act, the lack of suitable donor organs was still one of the limiting factors of this therapeutic procedure. One way out of this problem is to make so-called marginal organs usable, e.g. with the help of machine perfusion or by utilizing living liver donation, which are used in some countries for more than 90% of organ donations. In general, there is no difference in the indications for liver transplantation between a (partial) organ obtained by post-mortem or living donation. Before any living donation, a thorough evaluation of the donor is carried out in order to minimize postoperative morbidity as far as possible. Technically the partial liver donation is based on the oncological liver resection, while the partial liver transplantation is a further development of split liver transplantation after post-mortem liver donation. In specialized centers comparable or even better results can nowadays be achieved using living liver donation instead of post-mortem donation.
肝移植已成为治疗终末期肝病的标准手术。尽管在德国《移植法》修订之前，各方都付出了巨大努力，但缺乏合适的供体器官仍是这一治疗方法的限制因素之一。解决这一问题的一个方法是使所谓的边缘器官可用，例如借助机器灌注或利用活体肝捐赠，在一些国家，超过90%的器官捐赠采用这种方式。一般来说，通过尸检或活体捐赠获得的（部分）器官在肝移植适应症方面没有差异。在进行任何活体捐赠之前，都会对供体进行全面评估，以尽可能降低术后发病率。从技术上讲，部分肝捐赠基于肿瘤性肝切除，而部分肝移植是尸检肝捐赠后劈离式肝移植的进一步发展。如今，在专业中心，使用活体肝捐赠而非尸检捐赠可取得相当甚至更好的效果。
