利用腹腔镜肝切除术“废弃肝”行活体肝移植的思考

Reflection about using the otherwise discarded partial liver after laparoscopic hepatectomy for living donor liver transplantation

肝移植是挽救终末期肝病及急性肝衰竭病人生命的唯一有效手段,但供肝短缺限制了肝移植的临床应用。利用肝脏良性肿瘤行腹腔镜肝切除术“废弃肝”行活体肝移植鲜有报道,针对供者选择、手术适应证、术前评估、手术规划、操作流程及技术要点等方面缺乏相应的实施标准和规范。笔者基于所在中心腹腔镜肝切除术临床实践,结合相关文献,深入剖析利用腹腔镜肝切除术“废弃肝”行活体肝移植的可行性及问题。

Liver transplantation is the only effective way to save the lives of patients with end-stage liver disease and acute liver failure,but the shortage of donor liver limits the clinical application of liver transplantation.There is few report on living donor liver transplantation using the otherwise discarded partial liver after laparoscopic hepatectomy for benign liver tumor,and there are no corresponding standards and specifications for donor selection,surgical indications,preoperative evaluation,surgical planning,operation process and technical points.Based on the clinical practice of laparoscopic hepatectomy,and combined with relevant literature,the author discusses the feasibility and problems of using the otherwise discarded partial liver after laparoscopic hepatectomy for living donor liver transplantation.