Living donor liver transplantation in adults: recent advances and results.
Living donor liver transplantation in adults: recent advances and results.
复制标题
成人活体肝移植：最新进展和结果。
DOI：
10.1067/msy.2002.126870
复制
发表时间：
2002
期刊：
影响因子：
3.8
通讯作者：
N. Kokudo
中科院分区：
文献类型：
--
作者：
Y. Sugawara;M. Makuuchi;H. Imamura;J. Kaneko;T. Ohkubo;Y. Matsui;N. Kokudo
背景
活体肝移植（LDLT）目前已广泛应用于成人患者，以解决尸体器官严重短缺的问题。本研究的目的是分析单中心成人LDLT的经验。
方法
82例连续的成人LDLT手术根据移植时代和术前条件和适应症分为3组：1996年至1999年的所有患者（第1组，n = 30），2000年至2001年11月的高风险患者（第2组，n = 28）和低风险患者（第3组，n = 24）。至1999年，所有患者均采用左肝移植。此后，仅为低风险患者选择右肝。检查并比较各组的术前状态、发病率、住院时间、术后移植物功能和存活率。
结果
第1组和第2组的比较显示，在住院时间和生存率方面存在显著差异。相比之下，第2组和第3组的短期手术结果相当。2年生存率分别为84%、100%和88%。
结论
目前的结果表明，我们的移植物选择标准是可以接受的。小的移植物可以提供令人满意的结果时，用于良好的风险患者和右肝移植可能是有益的低风险患者。
BACKGROUND
Living donor liver transplantation (LDLT) is now widely performed for adult patients to resolve the critical shortage of organs from cadavers. The objective of this study was to analyze the experience of a single center with adult LDLT.
METHODS
Eighty-two consecutive LDLT procedures for adults were divided into 3 groups according to the transplant era and the preoperative condition and indications: all patients between 1996 and 1999 (Group 1, n = 30), good-risk patients between 2000 and November 2001 (Group 2, n = 28), and poor-risk patients (Group 3, n = 24). Up to 1999, left liver graft was used for all patients. Thereafter, right liver was selected only for poor-risk patients. Preoperative status, morbidity, hospital duration, and postoperative graft function and survival rate were examined and compared among the groups.
RESULTS
Comparison of groups 1 and 2 revealed a significant difference in the hospital duration and the survival rate. In contrast, the short-term surgical results were comparable between groups 2 and 3. The 2-year survival rates were 84%, 100%, and 88%, respectively.
CONCLUSIONS
The present results suggest that our graft selection criteria are acceptable. A small graft can provide satisfactory results when used in good-risk patients and a right liver graft may be beneficial in poor-risk patients.