• 華中科技大學(xué)同濟(jì)醫(yī)院同濟(jì)醫(yī)學(xué)器官移植研究所（武漢430030）;

進(jìn)入21世紀(jì)以來(lái)，肝移植已經(jīng)成為治療終末期肝臟疾病、急性暴發(fā)性肝功能衰竭的一種最有效的選擇。據(jù)美國(guó)UNOS報(bào)道，在過(guò)去10年中，全世界已實(shí)施26 040例肝移植； 在先進(jìn)的移植中心，肝移植受者的1年和3年存活率分別達(dá)到90%和80%，5年存活率達(dá)65%～75%，兒童肝移植和親屬活體肝移植存活率更高，除了存活時(shí)間延長(zhǎng)外，生活質(zhì)量得到明顯改善，包括恢復(fù)工作和生育能力。國(guó)內(nèi)近年來(lái)肝移植也得到快速發(fā)展，年移植數(shù)在千例左右，開(kāi)展的單位不斷增加，存活率得到提高，在先進(jìn)的單位，開(kāi)展的項(xiàng)目和水平逐漸接近國(guó)際水平。

引用本文： 陳實(shí). 肝移植現(xiàn)狀與面臨的挑戰(zhàn). 中國(guó)普外基礎(chǔ)與臨床雜志, 2003, 10(4): 315-317. doi: 復(fù)制

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2. Lo CM. Complications and longterm outcome of living liver donors: a survey of 1,508 cases in five Asian centers [J]. Transplantation， 2003; 75(3 Suppl)∶ S12.
3. Surman OS. The ethics of partialliver donation [J]. N Engl J Med, 2002; 346(14)∶1038.
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8. de Villa VH, Chen YS, Chen CL. Hepatitis B core antibodypositive grafts: recipient’s risk [J]. Transplantation, 2003; 75(3 Suppl)∶S49.
9. Hwang S， Moon DB， Lee SG，et al. Safety of antihepatitis B core antibodypositive donors for livingdonor liver transplantation [J]. Transplantation, 2003; 75(3 Suppl)∶S45.
10. Lo CM, Fan ST, Liu CL, et al. Prophylaxis and treatment of recurrent hepatitis B after liver transplantation [J]. Transplantation, 2003; 75(3 Suppl)∶S41.
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12. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for treatment of small hepatocellular carcinomas in patients with cirrhosis [J]. N Engl J Med, 1996; 334(11)∶693.
13. De Vreede I, Steers JL, Burch PA, et al. Prolonged diseasefree survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma [J]. Liver Transpl, 2000; 6(3)∶309.
14. Opelz G, Margreiter R, Dohler B. Prolongation of longterm kidney graft survival by a simultaneous liver transplant: the liver does it, and the heart does it too [J]. Transplantation, 2002; 74(10)∶1390.
15. Neumann UP， Guckelberger O， Langrehr JM, et al.Impact of human leukocyte antigen matching in liver transplantation [J]. Transplantation， 2003; 75(1)∶132.
16. Bilir BM, Guinette D, Karrer F, et al. Hepatocyte transplantation in acute liver failure [J]. Liver Transpl, 2000; 6(1)∶32.
17. Kren BT， Chowdhury NR， Chowdhury JR，et al. Gene therapy as an alternative to liver transplantation [J]. Liver Transpl， 2002; 8(12)∶1089.
18. Uekei T, Kaneda Y, Tsutsui H, et al. Hepatocyte growth factor gene therapy of liver cirrhosis in rat [J]. Nat Med, 1999； 5(2)∶226.
19. Starzl TE, Fung J, Tzakis A, et al. Baboontohuman liver transplantation [J]. Lancet, 1993; 341(8837)∶65.
20. Horslen SP, Hammel JM, Fristoe LW, et al. Extracorporeal liver perfusion using human and pig livers for acute liver failure [J]. Transplantation, 2000； 70(10)∶1472.
21. Dekel B, Burakova T, Arditti FD, et al. Human and porcine early kidney precursors as a new source for transplantation [J]. Nat Med, 2003; 9(1)∶53.
22. Kaihara S, Borenstein J, Koka R, et al. Silicon micromachining to tissue engineer branched vascular channels for liver fabrication [J]. Tissue Eng, 2000; 6(2)∶105.
  1. 1. Chen CL, Fan ST, Lee SG, et al. Livingdonor liver transplantation: 12 years of experience in Asia [J]. Transplantation， 2003; 75(3 Suppl)∶S6.
  2. 2. Lo CM. Complications and longterm outcome of living liver donors: a survey of 1,508 cases in five Asian centers [J]. Transplantation， 2003; 75(3 Suppl)∶ S12.
  3. 3. Surman OS. The ethics of partialliver donation [J]. N Engl J Med, 2002; 346(14)∶1038.
  4. 4. Cuende N， Grande L， Sanjuan F，et al. Liver transplant with organs from elderly donors: Spanish experience with more than 300 liver donors over 70 years of age [J]. Transplantation, 2002; 73(8)∶1360.
  5. 5. Inomata Y, Nakamura T,Uemoto S, et al.Domino splitliver transplantation from a living donor: case reports of in situ and ex situ splitting [J]. Liver Transpl, 2001; 7(2)∶150.
  6. 6. Tanabe M, Shimazu M, Wakabayashi G，et al. Intraportal infusion therapy as a novel approach to adult ABOincompatible liver transplantation [J]. Transplantation, 2002; 73(12)∶1959.
  7. 7. Narayanan Menon KV, Poterucha JJ, ElAmin OM, et al.Treatment of posttransplantation recurrence of hepatitis C with interferon and ribavirin:lessons on tolerability and efficacy [J]. Liver Transpl, 2002; 8(7)∶623.
  8. 8. de Villa VH, Chen YS, Chen CL. Hepatitis B core antibodypositive grafts: recipient’s risk [J]. Transplantation, 2003; 75(3 Suppl)∶S49.
  9. 9. Hwang S， Moon DB， Lee SG，et al. Safety of antihepatitis B core antibodypositive donors for livingdonor liver transplantation [J]. Transplantation, 2003; 75(3 Suppl)∶S45.
  10. 10. Lo CM, Fan ST, Liu CL, et al. Prophylaxis and treatment of recurrent hepatitis B after liver transplantation [J]. Transplantation, 2003; 75(3 Suppl)∶S41.
  11. 11. Vivarelli M, Bellusci R, Cucchetti A, et al. Low recurrence rate of hepatocellular carcinoma after liver transplantation: better patient selection or lower immunosuppression? [J]. Transplantation, 2002; 74 (12)∶1746.
  12. 12. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for treatment of small hepatocellular carcinomas in patients with cirrhosis [J]. N Engl J Med, 1996; 334(11)∶693.
  13. 13. De Vreede I, Steers JL, Burch PA, et al. Prolonged diseasefree survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma [J]. Liver Transpl, 2000; 6(3)∶309.
  14. 14. Opelz G, Margreiter R, Dohler B. Prolongation of longterm kidney graft survival by a simultaneous liver transplant: the liver does it, and the heart does it too [J]. Transplantation, 2002; 74(10)∶1390.
  15. 15. Neumann UP， Guckelberger O， Langrehr JM, et al.Impact of human leukocyte antigen matching in liver transplantation [J]. Transplantation， 2003; 75(1)∶132.
  16. 16. Bilir BM, Guinette D, Karrer F, et al. Hepatocyte transplantation in acute liver failure [J]. Liver Transpl, 2000; 6(1)∶32.
  17. 17. Kren BT， Chowdhury NR， Chowdhury JR，et al. Gene therapy as an alternative to liver transplantation [J]. Liver Transpl， 2002; 8(12)∶1089.
  18. 18. Uekei T, Kaneda Y, Tsutsui H, et al. Hepatocyte growth factor gene therapy of liver cirrhosis in rat [J]. Nat Med, 1999； 5(2)∶226.
  19. 19. Starzl TE, Fung J, Tzakis A, et al. Baboontohuman liver transplantation [J]. Lancet, 1993; 341(8837)∶65.
  20. 20. Horslen SP, Hammel JM, Fristoe LW, et al. Extracorporeal liver perfusion using human and pig livers for acute liver failure [J]. Transplantation, 2000； 70(10)∶1472.
  21. 21. Dekel B, Burakova T, Arditti FD, et al. Human and porcine early kidney precursors as a new source for transplantation [J]. Nat Med, 2003; 9(1)∶53.
  22. 22. Kaihara S, Borenstein J, Koka R, et al. Silicon micromachining to tissue engineer branched vascular channels for liver fabrication [J]. Tissue Eng, 2000; 6(2)∶105.