Current status of adult living donor liver transplantation
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摘要:
随着合理的选择标准的建立和持续的技术改进,活体肝移植已经得到了广泛的开展。右半肝活体肝移植已经在许多中心成为常规开展的术式。近年来,出于对供体安全性的考虑,其他移植物类型也成为成人间活体肝移植的一个重要选择,尤其是左半肝活体肝移植,成为成人活体肝移植的主要进展之一,并且取得了良好的结果。虽然微创技术存在一定的技术和安全问题,但由于其具有独特的优势,在供肝切除中将起到重要的作用。对于肝细胞癌患者,目前研究数据存在争议,但活体肝移植可用于肝细胞癌患者的治疗,应根据个体化原则,综合分析供体安全性、手术风险、受体的生存结果,谨慎选择。
Abstract:With the establishment of reasonable selection criteria and continuous technical refinement,living donor liver transplantation( LDLT) has been widely performed in the world. Right- lobe LDLT has become the conventional procedure performed at many centers. In recent years,due to the considerations of donor safety,other graft types have become important choices for adult- adult LDLT,especially left-lobe LDLT,and good outcome has been achieved. Although the minimally invasive technique has certain technical and safety issues,it will play an important role in donor hepatectomy due to its unique advantages. At present,the research data for patients with hepatocellular carcinoma( HCC) are controversial,but LDLT can be applied in the treatment for these patients. The therapeutic regimens for LDLT should be selected on the basis of the individualized principle and comprehensive analysis of donor safety,surgical risk,and the recipient's survival.
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Key words:
- liver transplantation /
- living donor
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