Barriers to the successful treatment of liver disease by hepatocyte transplantation.
Barriers to the successful treatment of liver disease by hepatocyte transplantation.
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DOI：
10.1016/j.jhep.2010.05.010
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发表时间：
2010-10
影响因子：
25.7
通讯作者：
Fox IJ
中科院分区：
文献类型：
--
作者：
Soltys KA;Soto-Gutiérrez A;Nagaya M;Baskin KM;Deutsch M;Ito R;Shneider BL;Squires R;Vockley J;Guha C;Roy-Chowdhury J;Strom SC;Platt JL;Fox IJ
肝衰竭和肝代谢紊乱患者的管理复杂且昂贵。肝衰竭导致凝血功能受损、意识和脑功能改变、多器官系统衰竭和脓毒症的风险增加。这些多方面的问题只有在今天和可预见的未来通过移植才能治疗。事实上，全肝移植或辅助性部分肝移植通常是治疗严重肝功能衰竭（即使是短暂的）的唯一选择。具有危及生命的基于肝脏的代谢紊乱的患者同样需要器官移植，即使他们的代谢疾病通常是单一酶缺乏的结果，并且肝脏在其他方面功能正常。尽管肝移植可能带来所有的好处，但它并不是一种理想的治疗方法，即使是对严重的肝功能衰竭也是如此。目前在美国有超过17，000名患者等待肝移植，这一数字严重低估了需要治疗的患者人数，因为据估计，超过100万患者可以从移植中受益。不幸的是，使用全肝移植治疗这些疾病受到供体严重短缺和与大手术相关的受体风险的限制。
Management of patients with hepatic failure and liver-based metabolic disorders is complex and expensive. Hepatic failure results in impaired coagulation, altered consciousness and cerebral function, a heightened risk of multiple organ system failure, and sepsis. Such manifold problems are only treatable today and for the foreseeable future by transplantation. In fact, whole or auxiliary partial liver transplantation is often the only available treatment option for severe, even if transient, hepatic failure. Patients with life-threatening liver-based metabolic disorders similarly require organ transplantation even though their metabolic diseases are typically the result of a single enzyme deficiency, and the liver otherwise functions normally. For all of the benefits it may confer, liver transplantation is not an ideal therapy, even for severe hepatic failure. More than 17,000 patients currently await liver transplantation in the United States, a number that seriously underestimates the number of patients that need treatment, as it has been estimated that more than a million patients could benefit from transplantation. Unfortunately, use of whole liver transplantation to treat these disorders is limited by a severe shortage of donors and by the risks to the recipient associated with major surgery.
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