Liver transplantation in Japan
Liver transplantation in Japan
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DOI：
10.1002/lt.24502
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发表时间：
2016-10-01
影响因子：
4.6
通讯作者：
Egawa, Hiroto
中科院分区：
文献类型：
--
作者：
Soyama, Akihiko;Eguchi, Susumu;Egawa, Hiroto
截至2014年12月31日，日本67家机构共进行了7937例肝移植（7673例活体供体移植和264例死亡供体肝移植[DDLT; 261例来自心脏跳动供体，3例来自无心脏跳动供体]）。日本经修订的《器官移植法》于2010年7月生效，该法律允许在家属同意的情况下，从包括儿童在内的脑死亡者身上获取器官，前提是患者此前没有拒绝器官捐赠。然而，死者捐赠器官的数量并没有像预期的那样增加。每百万人口的死亡器官捐献率（pmp）一直保持在1以下。为了尽量提高有限的捐赠器官的生存能力，采用了一种制度，其中包括训练有素的移植顾问医生和当地医生的伙伴关系。为了弥补现场培训机会的减少，还为移植外科医生建立了关于优质器官采购的教育制度。此外，肝移植领域的专家目前正在讨论采用终末期肝病模型评分进行分配，推广劈离式肝移植，安排内部协调员，并提高向家属提出器官捐献选择的频率。为了克服在努力促进器官捐献过程中供体短缺的问题，活体肝移植（LDLT）在日本已经发展起来。除了LDLT的成功经验外，继续努力增加DDLT将为更多患者增加肝移植的获益。肝移植22 1401-1407 2016 AASLD。
As of December 31, 2014, 7937 liver transplants (7673 living donor transplants and 264 deceased donor liver transplantations [DDLTs; 261 from heart-beating donors and 3 from non-heart-beating donors]) have been performed in 67 institutions in Japan. The revised Organ Transplant Law in Japan came into effect in July 2010, which allows organ procurement from brain-dead individuals, including children, with family consent if the patient had not previously refused organ donation. However, the number of deceased donor organ donations has not increased as anticipated. The rate of deceased organ donations per million population (pmp) has remained at less than 1. To maximize the viability of the limited numbers of donated organs, a system has been adopted that includes the partnership of well-trained transplant consultant doctors and local doctors. For compensating for the decreased opportunity of on-site training, an educational system regarding quality organ procurement for transplant surgeons has also been established. Furthermore, experts in the field of liver transplantation are currently discussing adoption of the Model for End-Stage Liver Disease score for allocation, promoting split-liver transplantation, arranging in-house coordinators, and improving the frequency of proposing the option to donate organs to the families. To overcome the shortage of donors during efforts to promote organ donation, living donor liver transplantation (LDLT) has been developed in Japan. Continuous efforts to increase DDLT in addition to the successful experience of LDLT will increase the benefits of liver transplantation for more patients. Liver Transplantation 22 1401-1407 2016 AASLD.