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亚洲肝脏移植的趋势。

Trends of liver transplantation in Asia.

作者信息

Pang Ning Qi, Chan Albert C Y, Kow Alfred Wei Chieh

机构信息

Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, National University Health System, NUHS Tower Block, 1E, Kent Ridge Road, Level 8, Singapore, 119228, Singapore.

National University Centre for Organ Transplantation (NUCOT), National University Hospital, National University Health System, Singapore, Singapore.

出版信息

Updates Surg. 2024 Jul 24. doi: 10.1007/s13304-024-01924-1.

Abstract

Liver transplantation (LT) in Asia started comparatively early in 1964, just 1 year after Starzl's trail-blazing first attempt. Despite the quick start, LT was slow to develop in this region. Limited access to universal healthcare, lack of public understanding and support as well as the absence of strong legislation, on a backdrop of a wide range of diverse social, religious, economic and cultural background are all contributory factors. Through strong administrative efforts, the number of DDLTs in selected Asian countries has been slowly rising in recent years. However, Asians are generally still less likely to donate organs than Caucasians after death. The strong demand for LT with limited access to deceased organs has, therefore, led to constant need for innovation in LT this region, with the pioneering of various LDLT techniques and safe expansion of donor pool being driven primarily by Asian centers. Familiarity and the development of technical expertise in donor surgery have also resulted in Asian centers repeatedly pushing the boundaries on minimally invasive donor and recipient surgery. In this article, we focus on the past and present states of LT in Asia and explore the future trends of LT in this region.

摘要

亚洲的肝脏移植(LT)起步相对较早,始于1964年,仅在斯塔兹开创性的首次尝试后一年。尽管起步迅速,但LT在该地区的发展较为缓慢。在广泛多样的社会、宗教、经济和文化背景下,全民医疗保健服务获取有限、公众缺乏理解与支持以及缺乏强有力的立法,都是促成因素。通过强有力的行政努力,近年来选定亚洲国家的尸体供肝肝移植(DDLT)数量一直在缓慢上升。然而,亚洲人死后捐献器官的可能性总体上仍低于白种人。对LT的强烈需求与获取尸体器官的机会有限,因此导致该地区LT不断需要创新,各种活体肝移植(LDLT)技术的开拓以及供体库的安全扩大主要由亚洲中心推动。对供体手术的熟悉和技术专长的发展也促使亚洲中心不断突破微创供体和受体手术的界限。在本文中,我们关注亚洲LT的过去和现状,并探讨该地区LT的未来趋势。

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