Agostini Carlotta, Buccianti Simone, Risaliti Matteo, Fortuna Laura, Tirloni Luca, Tucci Rosaria, Bartolini Ilenia, Grazi Gian Luca
Department of Experimental and Clinical Medicine, AOU Careggi, 50134 Florence, Italy.
J Clin Med. 2023 Sep 24;12(19):6173. doi: 10.3390/jcm12196173.
Liver transplantation (LT) is the treatment of choice for liver failure and selected cases of malignancies. Transplantation activity has increased over the years, and indications for LT have been widened, leading to organ shortage. To face this condition, a high selection of recipients with prioritizing systems and an enlargement of the donor pool were necessary. Several authors published their case series reporting the results obtained with the use of marginal donors, which seem to have progressively improved over the years. The introduction of in situ and ex situ machine perfusion, although still strongly debated, and better knowledge and treatment of the complications may have a role in achieving better results. With longer survival rates, a significant number of patients will suffer from long-term complications. An extensive review of the literature concerning short- and long-term outcomes is reported trying to highlight the most recent findings. The heterogeneity of the behaviors within the different centers is evident, leading to a difficult comparison of the results and making explicit the need to obtain more consent from experts.
肝移植(LT)是肝衰竭及特定恶性肿瘤病例的首选治疗方法。多年来,移植活动不断增加,肝移植的适应证也有所拓宽,导致器官短缺。为应对这种情况,有必要通过优先排序系统对受者进行严格筛选,并扩大供体库。几位作者发表了他们的病例系列,报告了使用边缘供体所取得的结果,这些结果多年来似乎在逐步改善。原位和异位机器灌注的引入,尽管仍存在激烈争论,以及对并发症更好的认识和治疗可能有助于取得更好的效果。随着生存率的提高,大量患者将出现长期并发症。本文对有关短期和长期结果的文献进行了广泛综述,试图突出最新发现。不同中心行为的异质性很明显,这导致结果难以比较,并明确表明需要从专家那里获得更多共识。