劈离式肝移植技术的临床应用

Clinical application of split liver transplantation technique

目前,临床肝移植存在供肝短缺、等待肝移植患者数量日益增加、缺乏匹配的供者等困难,部分儿童和成人患者接受肝移植手术的机会渺茫,同时也限制了肝移植的进一步发展。在此背景下,劈离式肝移植应运而生,其将1个供肝供给2例及多例受者移植,有效增加了供肝的利用率,缓解了供肝短缺的矛盾。随着劈离式肝移植技术越发成熟,其存活率可与全肝移植相当,许多移植中心也已将劈离式肝移植作为常规手术方式。本文就劈离式肝移植技术的发展、供受者的选择与匹配、供肝的劈离与重建技术及术后并发症做一综述,以期为临床劈离式肝移植的进一步发展提供参考,增加更多终末期肝病患者接受肝移植的机会。

Currently,multiple difficulties exist in clinical liver transplantation,such as shortage of donor liver,increasing quantity of patients waiting for liver transplantation and lack of matching donors,etc.Some children and adult patients have little chance of undergoing liver transplantation,which also limits the development of liver transplantation.In this context,split liver transplantation emerges,in which 1 donor liver can be applied to 2 or even more recipients.It may effectively increase the utilization rate of donor liver and alleviate the shortage of donor liver.With the development of split liver transplantation,the survival rate of split liver transplantation is comparable to that of total liver transplantation.Multiple transplantation centers have routinely adopted split liver transplantation.In this article,the development of split liver transplantation,the selection and matching of donors and recipients,the split and reconstruction techniques of donor liver and postoperative complications were reviewed,aiming to provide reference for subsequent development of split liver transplantation in clinical practice and increase the chance of liver transplantation for more patients diagnosed with end-stage liver diseases.