双供者肝移植技术的临床应用

Clinical application of dual-donor liver transplantation

  • 摘要: 肝移植是治疗进展性、不可逆性终末期肝病的根治性手段,但其临床推广始终受限于供肝匮乏这一核心瓶颈。活体肝移植可在一定程度上缓解供肝紧张,但需要保障供者剩余肝体积以规避肝功能不全及移植物与受者质量比不足,以预防小肝综合征,临床应用受限。双供者肝移植技术是通过整合两例供者部分肝组织作为移植物,在保障供者安全、规避受者小肝综合征、拓宽供肝来源的同时,显著提升了供肝利用率,有效缓解了供肝短缺的临床矛盾。本文结合近年来国内外临床实践及最新诊疗指南,从双供者肝移植技术的发展背景、供受者评估与筛选、手术方式与术后并发症等方面展开系统综述,旨在为双供者肝移植技术的规范化推广与临床优化提供参考。

     

    Abstract: Liver transplantation is a radical treatment for progressive and irreversible end-stage liver disease. However, its clinical application has always been restricted by the core bottleneck of donor liver shortage. Living donor liver transplantation can alleviate the shortage of donor livers to a certain extent, but it requires simultaneous assurance of sufficient residual liver volume in donors to avoid liver insufficiency, as well as an adequate graft-to-recipient weight ratio to prevent small-for-size syndrome, which limits its clinical application. Dual-donor liver transplantation utilizes partial liver tissues from two donors as grafts. While ensuring donor safety, avoiding small-for-size syndrome in recipients, and expanding the donor pool, this technique significantly improves the utilization rate of donor livers and effectively eases the clinical contradiction of donor liver shortage. Based on recent domestic and international clinical practices and the latest diagnosis and treatment guidelines, this article systematically reviews the developmental background, donor and recipient evaluation and selection, surgical procedures and postoperative complications of dual-donor liver transplantation, aiming to provide references for the standardized promotion and clinical optimization of this technique.

     

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