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对LDLT的说明:一个不断变化的途径?

Stefano Di Sandro1,2, Deniz Balci3, Fabrizio Di Benedetto4,5

  • 1Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, MO, Italy. stefano.disandro@unimore.it.

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概括

通过更好的接受者选择和手术技术,活体供体肝移植 (LDLT) 的结果得到了改善. 在肝脏瘤治疗中,LDLT越来越重要,比其他选择提供生存优势.

关键词:
染色直肠肝脏发生的变异.肝细胞癌是肝细胞癌.活体供体肝移植活体供体肝移植移植瘤学 移植瘤学

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科学领域:

  • 肝病学 肝病学是一种肝病学.
  • 移植手术 移植手术
  • 手术瘤学手术瘤学

背景情况:

  • 肝移植 (LT) 提供了肝硬化治疗方法,在5年内有超过80%的存活率.
  • 肝硬化,有或没有肝细胞癌 (HCC),是LT的主要原因.
  • 活体供体肝移植 (LDLT) 最初的结果较差,但已经显著改善.

研究的目的:

  • 审查LDLT的进展和不断变化的作用.
  • 为了突出LDLT在移植瘤学中的日益重要.
  • 讨论受体选择和外科创新对LDLT结果的影响.

主要方法:

  • 关于LDLT结果和适应症的研究综述.
  • 对接受者选择标准和捐赠者/接受者匹配的分析.
  • 评估新兴技术,如RAPID技术和最少侵入性的方法.
  • 评估LDLT在治疗肝脏瘤中的作用,包括结直肠肝脏转移 (CLM).

主要成果:

  • 通过精确的接受者选择和捐赠者/接受者匹配,LDLT结果得到了改善.
  • 先进的技术,如左叶偏好和最小入侵的方法提高LDLT的成功.
  • 拉皮德技术对肝硬化和非肝硬化肝脏都显示出有前途.
  • 与替代药物相比,LDLT为像CLM这样的肝脏瘤提供了更好的生存率,最佳时间包括化疗.

结论:

  • LDLT正在成为肝移植的关键选择,特别是在瘤学中.
  • 随着与病毒相关的肝硬化减少,LDLT的作用正在扩大.
  • 在特定的癌症情景中,LDLT可以超过已故供体移植,改善患者的生存率.