TIMELINE Liver transplantation: past, present and future
TIMELINE Liver transplantation: past, present and future
复制标题
DOI：
10.1038/nrgastro.2013.88
复制
发表时间：
2013-07-01
影响因子：
65.1
通讯作者：
Busuttil, Ronald W.
中科院分区：
文献类型：
--
作者：
Zarrinpar, Ali;Busuttil, Ronald W.
首例人类肝脏移植手术是由托马斯·斯塔兹于1963年进行的。在接下来的20年里，供体器官质量、受体选择、手术和围手术期管理、免疫抑制和感染并发症等方面都存在困难。这些领域的进展都将肝移植从一个实验性程序转变为终末期肝病和某些癌症的标准治疗方法。肝移植已从少数几个开创性规划扩展到80多个国家的数百个规划。1年生存率超过80%，治疗效果持续改善。这种成功也带来了障碍。肝移植目前面临的挑战包括供体器官短缺、移植时受者疾病更严重、再次移植的需求日益增长、长期免疫抑制相关的毒性和不良反应、肥胖和NASH流行、HCV复发以及肝细胞癌的生物学仍然难以理解。本展望总结了这一转变，并详细介绍了未来的一些挑战。
The first human liver transplant operation was performed by Thomas Starzl in 1963. The next two decades were marked by difficulties with donor organ quality, recipient selection, operative and perioperative management, immunosuppression and infectious complications. Advances in each of these areas transformed liver transplantation from an experimental procedure to a standard treatment for end-stage liver disease and certain cancers. From the handful of pioneering programmes, liver transplantation has expanded to hundreds of programmes in >80 countries. 1-year patient survival rates have exceeded 80% and outcomes continue to improve. This success has created obstacles. Ongoing challenges of liver transplantation include those concerning donor organ shortages, recipients with more advanced disease at transplant, growing need for retransplantation, toxicities and adverse effects associated with long-term immunosuppression, obesity and NASH epidemics, HCV recurrence and the still inscrutable biology of hepatocellular carcinoma. This Perspectives summarizes this transformation over time and details some of the challenges ahead.