• 南京醫(yī)科大學(xué)第一附屬醫(yī)院肝臟外科，江蘇省肝臟移植中心（南京210029）;

自1989年巴西醫(yī)生Raia開(kāi)展人類(lèi)首例活體肝移植（living donor liver transplantation, LDLT）以來(lái)，LDLT受體的優(yōu)良預(yù)后及供體的安全性逐步得到了公認(rèn)，加之“腦死亡”供肝的嚴(yán)重匱乏，LDLT技術(shù)迅速發(fā)展并被公認(rèn)為是緩解供肝來(lái)源匱乏最有效的方法之一［1，2］。LDLT技術(shù)的發(fā)展大致經(jīng)歷了三個(gè)階段： ①成人→兒童間活體肝移植（簡(jiǎn)稱(chēng)兒童活體肝移植，pediatric living donor liver transplantation, PLDLT）； ②成人→成人間活體肝移植(adulttoadult living donor liver transplantation, ALDLT)； ③急診活體肝移植(emergency or highurgency living donor liver transplantation, ELDLT )。LDLT技術(shù)發(fā)展的每一階段均是對(duì)前一階段技術(shù)的總結(jié)和升華，技術(shù)難度和復(fù)雜性也逐步增加。

引用本文： 王學(xué)浩,李國(guó)強(qiáng). 再論活體肝移植. 中國(guó)普外基礎(chǔ)與臨床雜志, 2003, 10(4): 318-320. doi: 復(fù)制

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1. Emre S. Living donor liver transplantation: a critical review [J]. Transplant Proc, 2001; 33(7-8)∶3456.
2. Inomata Y, Uemoto S, Asonuma K, et al. Right lobe graft in living donor liver transplantation [J]. Transplantation, 2000; 69(2)∶258.
3. 王學(xué)浩, 杜競(jìng)輝, 張峰, 等. 首例活體供肝原位部分肝移植報(bào)告 [J]. 中國(guó)實(shí)用外科雜志, 1995; 15(5)∶273.
4. Schulz KH, Hofmann C, Sander K,et al. Living organ donation vs. cadaveric donationstudy of liver transplanted children and their families [J]. Psychother Psychosom Med Psychol, 2001; 51(12)∶452.
5. Beavers KL, Sandler RS, Fair JH,et al. The living donor experience: donor health assessment and outcomes after living donor liver transplantation [J]. Liver Transpl, 2001; 7(11)∶943.
6. 王學(xué)浩,張峰,李相成,等.五例活體肝移植供體術(shù)后隨訪報(bào)告 [J].江蘇醫(yī)藥, 2001; 27(10)∶729.
7. 王學(xué)浩,張峰,李相成,等.活體部分肝移植12例次臨床報(bào)告 [J].中華醫(yī)學(xué)雜志, 2002; 82(7)∶19.
8. Marcos A. Right lobe living donor liver transplantation: a review [J]. Liver transpl， 2000; 6(1)∶3.
9. 李國(guó)強(qiáng),王學(xué)浩.活體肝移植臨床研究的新進(jìn)展 [J].中國(guó)普外基礎(chǔ)與臨床雜志, 2002; 9(4)∶279.
10. Fan ST, Lo CM, Liu CL, et al. Safety of donors in live donor liver transplantation using right lobe grafts [J].Arch Surg, 2000; 135(3)∶336.
11. Marcos A, Fisher RA, Ham JM, et al. Right lobe living donor living transplantation [J].Transplantation, 1999; 68(6)∶798.
12. Nakamura S, Suzuki S, Yokoi Y. Indications for and techniques of hepatic vein reconstruction in hepatectomy for hepatocellular carcinoma [J]. Nippon Geka Gakkai Zasshi, 2001; 102(11)∶805.
13. Sugawara Y, Makuuchi M, Takayama T,et al. Right lateral sector graft in adult livingrelated liver transplantation [J]. Transplantation, 2002; 73(1)∶111.
14. Sugawara Y, Makuuchi M, Takayama T,et al. Liver transplantation using a right lateral sector graft from a living donor to her granddaughter [J]. Hepatogastroenterology, 2001; 48 (37)∶261.
15. 王學(xué)浩, 李國(guó)強(qiáng), 李相成, 等. 活體肝移植手術(shù)經(jīng)驗(yàn)回顧 [J]. 中國(guó)實(shí)用外科雜志, 2002; 22(6)∶89.
16. Kelly D, Jara P, Rodeck B, et al. Tacrolimus dual therapy versus cyclosporinmicroemulsion triple therapy in paediatric liver transplantation: results from a multicentre randomized trial [J]. Am J Transpl， 2002; 2(Suppl 3)∶351.
17. Kumar A, Jain B, Polharna R, et al. Tacrolimus offers almost total absence of chronic rejection in pediatric liver transplant recipient: follow up of 7-10 years [J]. Am J Transpl, 2002; 2(Suppl 3)∶352.
18. Uemoto S, Inomata Y, Sakuri T, et al. Living donor liver transplantation for fulminant hepatic failure [J].Transplantation, 2000; 70(1)∶152.
19. Bismuth H, Samuel D, Castaing D, et al. Orthotopic liver transplantation in fulminant and subfulminant hepatitis. The Paul Brouses experience [J]. Ann Surg, 1995; 222(2)∶109.
20. Washburn WK, Bradley J, Cosimi AB, et al. A regional experience with emergency liver transplantation [J].Transplantation,2000; 61(2)∶235.
21. Lo CM, Fan ST, Liu CL, et al. Applicability of living donor liver transplantation to highurgency patients [J]. Transplantation,1999; 67(1)∶73.
22. Marcos A, Ham JM, Fisher RA, et al. Emergency adult to adult living donor liver transplantation for fulminant hepatic failure [J].Transplantation, 2000; 69(10)∶2202.
  1. 1. Emre S. Living donor liver transplantation: a critical review [J]. Transplant Proc, 2001; 33(7-8)∶3456.
  2. 2. Inomata Y, Uemoto S, Asonuma K, et al. Right lobe graft in living donor liver transplantation [J]. Transplantation, 2000; 69(2)∶258.
  3. 3. 王學(xué)浩, 杜競(jìng)輝, 張峰, 等. 首例活體供肝原位部分肝移植報(bào)告 [J]. 中國(guó)實(shí)用外科雜志, 1995; 15(5)∶273.
  4. 4. Schulz KH, Hofmann C, Sander K,et al. Living organ donation vs. cadaveric donationstudy of liver transplanted children and their families [J]. Psychother Psychosom Med Psychol, 2001; 51(12)∶452.
  5. 5. Beavers KL, Sandler RS, Fair JH,et al. The living donor experience: donor health assessment and outcomes after living donor liver transplantation [J]. Liver Transpl, 2001; 7(11)∶943.
  6. 6. 王學(xué)浩,張峰,李相成,等.五例活體肝移植供體術(shù)后隨訪報(bào)告 [J].江蘇醫(yī)藥, 2001; 27(10)∶729.
  7. 7. 王學(xué)浩,張峰,李相成,等.活體部分肝移植12例次臨床報(bào)告 [J].中華醫(yī)學(xué)雜志, 2002; 82(7)∶19.
  8. 8. Marcos A. Right lobe living donor liver transplantation: a review [J]. Liver transpl， 2000; 6(1)∶3.
  9. 9. 李國(guó)強(qiáng),王學(xué)浩.活體肝移植臨床研究的新進(jìn)展 [J].中國(guó)普外基礎(chǔ)與臨床雜志, 2002; 9(4)∶279.
  10. 10. Fan ST, Lo CM, Liu CL, et al. Safety of donors in live donor liver transplantation using right lobe grafts [J].Arch Surg, 2000; 135(3)∶336.
  11. 11. Marcos A, Fisher RA, Ham JM, et al. Right lobe living donor living transplantation [J].Transplantation, 1999; 68(6)∶798.
  12. 12. Nakamura S, Suzuki S, Yokoi Y. Indications for and techniques of hepatic vein reconstruction in hepatectomy for hepatocellular carcinoma [J]. Nippon Geka Gakkai Zasshi, 2001; 102(11)∶805.
  13. 13. Sugawara Y, Makuuchi M, Takayama T,et al. Right lateral sector graft in adult livingrelated liver transplantation [J]. Transplantation, 2002; 73(1)∶111.
  14. 14. Sugawara Y, Makuuchi M, Takayama T,et al. Liver transplantation using a right lateral sector graft from a living donor to her granddaughter [J]. Hepatogastroenterology, 2001; 48 (37)∶261.
  15. 15. 王學(xué)浩, 李國(guó)強(qiáng), 李相成, 等. 活體肝移植手術(shù)經(jīng)驗(yàn)回顧 [J]. 中國(guó)實(shí)用外科雜志, 2002; 22(6)∶89.
  16. 16. Kelly D, Jara P, Rodeck B, et al. Tacrolimus dual therapy versus cyclosporinmicroemulsion triple therapy in paediatric liver transplantation: results from a multicentre randomized trial [J]. Am J Transpl， 2002; 2(Suppl 3)∶351.
  17. 17. Kumar A, Jain B, Polharna R, et al. Tacrolimus offers almost total absence of chronic rejection in pediatric liver transplant recipient: follow up of 7-10 years [J]. Am J Transpl, 2002; 2(Suppl 3)∶352.
  18. 18. Uemoto S, Inomata Y, Sakuri T, et al. Living donor liver transplantation for fulminant hepatic failure [J].Transplantation, 2000; 70(1)∶152.
  19. 19. Bismuth H, Samuel D, Castaing D, et al. Orthotopic liver transplantation in fulminant and subfulminant hepatitis. The Paul Brouses experience [J]. Ann Surg, 1995; 222(2)∶109.
  20. 20. Washburn WK, Bradley J, Cosimi AB, et al. A regional experience with emergency liver transplantation [J].Transplantation,2000; 61(2)∶235.
  21. 21. Lo CM, Fan ST, Liu CL, et al. Applicability of living donor liver transplantation to highurgency patients [J]. Transplantation,1999; 67(1)∶73.
  22. 22. Marcos A, Ham JM, Fisher RA, et al. Emergency adult to adult living donor liver transplantation for fulminant hepatic failure [J].Transplantation, 2000; 69(10)∶2202.