在西欧开发成年活体捐赠者肝脏移植计划:鹿特丹体验
Alicia Jane Chorley1, Wojciech G Polak1, Khe C K Tran1
1Division of HPB and Transplant Surgery, Department of Surgery, Erasmus University Medical Centre, Erasmus MC Transplant Institute, Erasmus University Medical Centre, Rotterdam, Netherlands.
概括
活体供体肝移植 (LDLT) 为器官短缺提供了一个解决方案. 荷兰重新启动的LDLT计划实现了高患者和移植存活率,证明了成功的计划建立.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 外科手术程序开发项目
背景情况:
- 末期肝病需要进行肝移植 (LT).
- 有限的已故捐献器官造成了严重的器官短缺.
- 活体供体肝移植 (LDLT) 扩大了器官的可用性.
研究的目的:
- 描述建立一个成功的成人LDLT计划的关键步骤和结果.
- 报告荷兰LDLT的最初结果.
主要方法:
- 程序开发涉及市场分析,基于最佳实践的协议创建,以及严格的教育计划.
- 积极招募患者和LDLT的捐赠者.
- 通过捐赠者和接受者的发病率 (Clavien-Dindo等级≥3) 和死亡率来衡量结果.
主要成果:
- 在2019年1月至2024年8月期间,进行了54次LDLT.
- 捐赠者发病率包括3A (3%) 和3B (12%) 的并发症,没有捐赠者死亡率.
- 接受者结局:41%为PSC移植,平均MELD13,65%Roux-en-Y重建,40%经历并发症,2名接受者死亡.
- 患者和移植的生存率分别为97%和97%.
结论:
- 在荷兰成功建立了成年LDLT计划.
- 仔细规划和坚持可以克服建立LDLT计划的挑战.
- LDLT是一种可行的选择,可以增加肝移植器官的可用性.
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