活体肝脏移植的发展

Development of Living Related Liver Transplantation

活体肝脏移植是在尸体肝脏资源面临严重短缺的情况下发展起来的,在某些亚洲国家和地区由于传统观念的影响以及尚未接受脑死亡法,活体肝脏移植几乎是供肝的唯一来源。活体肝脏移植供肝者的选择和评价涉及特殊法律与伦理问题,活体供肝者的安全是第一位的,是活体肝脏移植能否为公众接受的关键。对肝脏解剖生理学的研究表明,成年人供出右半肝后剩下的左半肝完全可以行使正常的肝脏功能,供肝者术后发生死亡是极个别事件,而接受活体肝脏移植的受肝者近远期结果接近甚至优于尸体肝脏移植。我国大陆成人间活体肝脏移植已出现蓬勃发展的局面,移植数量迅速增加,供体的安全性进一步提高,有望在短期内发展成肝脏移植的重要形式。

Living related liver transplantation （LRLT） has been developed as a rescue for the ever deteriorating shortage of cadaveric donor liver, especially in Asian countries and areas where the concept of brain death has not widely been accepted. Inclusion criteria for the biologically suitable potential donor of LRLT should be strict and approved by the ethical committee of the hospital before clinical evaluation is taken. Anatomical, physiological and clinical practices have proved that donor mortality is acceptably very low. The early and middle-long term results for the recipient of LRLT is comparable with and even better than those of cadaveric liver transplantation. In China's Mainland, interest in LRLT is surging with the volume ever increased and donor＇s safety guaranteed.