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肝移植。过去十年。

Liver transplantation. The last ten years.

作者信息

Wood R P, Ozaki C F, Katz S M, Monsour H P, Dyer C H, Johnston T D

机构信息

Division of Immunology and Organ Transplantation, University of Texas Medical School, Hermann Hospital, Houston.

出版信息

Surg Clin North Am. 1994 Oct;74(5):1133-54.

PMID:7940065
Abstract

8960741 10 years have witnessed a number of changes in the liver transplant process. Key among these changes are the longer preservation times allowed with UW solution, the development of the new techniques for the transplantation of pediatric patients, and the reintroduction of xenotransplantation for both permanent and temporary hepatic support. Early referral and prompt transplant of patients are among the most important keys to successful transplantation. However, owing to the present organ allocation system and the lack of suitable organ donors, potential liver transplant recipients will continue to experience a significant mortality rate on the waiting list. In addition, owing to the long waiting times for suitable donor organs, many patients who would have been excellent low-risk candidates will deteriorate as their liver disease progresses and become high-risk patients for liver transplantation. Expanding the donor pool and modifying the present liver allocation system to shift the flow of organs to the better-risk patients will do more to improve the results of liver transplantation than any other change in the management and transplantation of patients with severe liver disease.

摘要

8960741 十年来,肝移植过程发生了诸多变化。这些变化中关键的有:UW 溶液允许更长的保存时间、小儿患者移植新技术的发展以及异种移植重新用于永久性和临时性肝支持。患者的早期转诊和及时移植是成功移植的最重要关键因素之一。然而,由于当前的器官分配系统以及合适器官供体的缺乏,潜在的肝移植受者在等待名单上仍将面临显著的死亡率。此外,由于等待合适供体器官的时间过长,许多原本会是优秀低风险候选者的患者会随着肝病进展而病情恶化,成为肝移植的高风险患者。扩大供体库并修改当前的肝分配系统,将器官流向转向风险较低的患者,对于改善严重肝病患者的管理和移植结果而言,比在严重肝病患者管理和移植方面的任何其他改变都更有作用。

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