肝移植 liver transplantation - PubMed 文献
PubMed 共收录约 150,227 篇相关文献，本站只列出其中相关度最高的前 50 篇（共 5 页）；要看全部结果、按影响因子 / 分区 / 年份筛选，请前往完整搜索。
关于 肝移植
肝脏移植（liver transplantation）是指将健康供体的全部或部分肝脏植入终末期肝病或急性肝衰竭患者体内，以替代其丧失功能的病肝的外科治疗手段。该技术属于器官移植学、肝胆外科学及移植免疫学的交叉领域，是治疗终末期肝病的有效方法之一。根据供体来源，可分为尸体供肝移植与活体供肝移植；根据植入方式，可分为原位肝移植与异位肝移植。中文常称“肝移植”，英文同义词包括 hepatic transplantation、liver graft 等。其核心环节涉及供肝获取、保存、血管与胆道重建以及术后免疫抑制治疗。
该领域的研究热点涵盖移植免疫耐受的诱导与维持、边缘供肝的评估与利用、缺血再灌注损伤的机制与保护策略、活体肝移植的供体安全与术后并发症防治、以及移植后原发病复发（如丙型肝炎、肝细胞癌）的监测与干预。经典议题包括排斥反应的分子机制、免疫抑制剂的个体化方案优化及长期生存质量评估。代表性期刊有 American Journal of Transplantation、Liver Transplantation、Transplantation 等，活跃学者分布于全球主要移植中心，研究内容常涉及临床队列分析与基础免疫学实验。
PubMed增强版可为关注肝脏移植的研究者与临床医生提供多项实用功能：支持中英文摘要对照翻译，帮助快速理解非母语文献；展示期刊影响因子与分区信息，辅助评估文献学术影响力；提供合法渠道的PDF全文下载链接，减少获取障碍；内置AI阅读工具可自动提炼研究目的、方法、结果与结论，提升文献筛选效率。这些功能有助于用户系统追踪肝移植领域的进展，优化科研与临床决策。
肝移植 的 PubMed 搜索结果
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Trends over a decade of pediatric liver transplantation in the United States. 美国儿童肝移植十年趋势
During the last 10 to 15 years, medical and surgical innovations have established pediatric liver transplantation as the optimal therapy for children suffering acute and chronic liver disease. We hypothesized that the profile of current pediatric liver transplant recipients would differ significantly from that of an earlier era. We collected and compared data regarding the characteristics of children undergoing liver transplantation alone in 2 eras separated by more than a decade from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database. Transplant recipients from March 1, 2002 to December 31, 2004, compared to those from January 1, 1990, to December 31, 1992, tended to be more evenly distributed across age, race/ethnicity, and disease etiology. There was a major shift toward utilization of partial grafts from both deceased and living donors to achieve transplantation for the youngest children (<1 and 1-5 yr) in particular. However, in spite of these innovative transplant strategies and only a modest increase in demand for pediatric liver transplantation, wait list times for both pediatric candidates and recipients have still increased between eras. In conclusion, the sobering reality that mortality on the waiting list remains highest for the youngest pediatric liver candidates frames our challenge for the next decade.
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Left Lobe Auxiliary Liver Transplantation for End-stage Hepatitis B Liver Cirrhosis. 左半肝辅助性肝移植治疗终末期乙型肝炎肝硬化
Auxiliary liver transplantation (ALT) for hepatitis B virus (HBV)-related liver cirrhosis previously showed poor results, because the native liver was a significant source of HBV recurrence and the graft could be rapidly destroyed by HBV infection in an immunosuppressive condition. Four patients with HBV-related liver cirrhosis were unable to undergo orthotopic liver transplantation because the only available grafts of left lobe were too small. Under entecavir-based anti-HBV treatment, they underwent ALT in which the recipient left liver was removed and the small left lobe graft was implanted in the corresponding space. The mean graft weight/recipient weight was 0.49% (range, 0.38%-0.55%). One year after transplantation, the graft sizes were increased to 273% and the remnant livers were decreased to 44%. Serum HBV DNA was persistently undetectable. Periodic graft biopsy showed no signs of tissue injury and negative immunostaining for hepatitis B surface antigen and hepatitis B core antigen. After a mean follow-up period of 21 months, all patients live well with normal graft function. Our study suggests that ALT for HBV-related liver cirrhosis is feasible under entecavir-based anti-HBV treatment. Successful application of small left livers in end-stage liver cirrhosis may significantly increase the pool of left liver grafts for adult patients.
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Orthotopic liver transplantation: T-tube or not T-tube? Systematic review and meta-analysis of results. 原位肝移植：放置T管还是不放置T管？系统评价与荟萃分析结果
The purpose of this study was to compare outcomes after duct-to-duct anastomoses with or without biliary T-tube in orthotopic liver transplantation. We pooled the outcomes of 1027 patients undergoing choledocho-choledochostomy with or without T-tube in 9 of 46 screened trials by means of fixed or random effects models. The "without T-tube" and "with T-tube" groups had equivalent outcomes for: anastomotic bile leaks or fistulas, choledocho-jejunostomy revisions, dilatation and stenting, hepatic artery thromboses, retransplantation, and mortality due to biliary complications. The "without T-tube" group had better outcomes when considering "fewer episodes of cholangitis," "fewer episodes of peritonitis," and showed a favorable trend for "overall biliary complications." Although the "with T-tube" group showed superior result for "anastomotic and nonanastomotic strictures," the incidence of interventions was not diminished. Our systematic review and meta analysis favor the abandonment of T-tubes in orthotopic liver transplantation.
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Living Donor Versus Deceased Donor Liver Transplantation for HCC. 活体供者与 deceased 供者肝移植治疗肝细胞癌的比较
Liver transplantation is the definitive treatment modality of the patients having an end-stage liver disease with hepatocellular carcinoma. The number of living donor liver transplantations has been increased because of the deceased donor organ shortage, especially in Asian countries. Reports of different clinics about the postoperative course and tumor recurrence rates comparing living donor versus deceased donor liver transplantations, besides patient selection criteria, are reviewed along with our clinic's experiences.
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A Comprehensive Review of Transesophageal Echocardiography During Orthotopic Liver Transplantation. 原位肝移植期间经食管超声心动图的综合综述
Orthotopic liver transplantation (OLT) is characterized by significant hemodynamic disturbances and anesthetic challenges. Intraoperative transesophageal echocardiography (TEE) can be used to guide management during these procedures. This review examines the role of echocardiography during OLT, presents common TEE findings during each phase of OLT, and discusses the benefits demonstrated with TEE use and the safety of TEE in this patient population. Finally, the authors propose an algorithm for the safe use of TEE during OLT.
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Potentials of regenerative medicine for liver disease. 再生医学在肝病中的潜力
Liver transplantation is still the only effective treatment for end-stage liver disease. However, because of the serious worldwide shortage of donated organs, an alternative cellular therapy would be desirable. Animal studies and preclinical trials have indicated that hepatocyte transplantation can serve as an alternative to liver transplantation. Unfortunately, however, the harvesting of hepatocytes is associated with the same problem as organ transplantation, i.e., a lack of a suitable cell source. Therefore, current stem cell technology, which is attempting to establish an unlimited supply of hepatocytes, would facilitate the clinical application of hepatocyte transplantation. This review summarizes current knowledge of embryonic and adult stem cell differentiation into hepatocytes and discusses how liver stem cells could be applied clinically in the future.
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From living related to in-situ split liver transplantation: how to reduce waiting-list mortality. 从活体相关到原位劈离式肝移植：如何降低等待名单死亡率
The insufficient number of suitable cadaveric organs for pediatric recipients is the cause of high pretransplant mortality rates and long waiting times. With the introduction of split and living related liver transplantation, the waiting list mortality rate has dropped from greater than 15% to less than 5% and children are transplanted more rapidly. A 5-year patient and graft survival rate of greater than 80% has been obtained in those centers where split and living related liver transplantations are routinely performed. The data analyzed in this paper show that the only current solution to cadaveric organ shortage is a 'multimodal' approach, where whole liver cadaveric transplantation is associated with split and living related liver transplantation.
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Bile duct strictures after liver transplantation. 肝移植术后胆管狭窄
Biliary complications account for relevant morbidity and mortality after liver transplantation. Advances have taken place in understanding their aetiology, in preventive operative techniques, imaging procedures, as well as interventional and endoscopic management. However, progress in living donation, donation after cardiac death as well as paediatric transplant procedures have changed the incidence and causes of biliary complications. This review summarizes recent progress in the field, particularly related to biliary strictures after liver transplantation. Significant findings in the period of interest for this review focussed on improvements of endoscopic treatment of postliver transplant biliary complications, including novel stenting devices, the routine analysis of bacterial and fungal flora, and the use of steroids to prevent postendoscopic retrograde cholangiopancreaticography pancreatitis. The importance of cytomegalovirus and hepatitis C in the aetiology of biliary complications was highlighted. Under certain circumstances, biliary complications after liver transplantation of organs secondary to donation after cardiac death may be reduced to a level known from liver transplantation after brain death. Further evidence was added to support the risk-adapted use of biliary drainage during liver transplantation. The ongoing research in the aetiology, prevention, and treatment of biliary strictures after liver transplantation highlights the significance of biliary complications for patient and graft outcome.
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Liver transplantation in an African setting. 非洲背景下的肝移植
Liver disease in children in the developing world is a frequent occurrence, which is generally inadequately managed because of lack of resources. However, increasingly, there has been a demand for liver transplantation, where primary medical or surgical therapies have failed. The expertise and infrastructure required for a successful outcome are no different from those in more developed countries; if anything, the challenges are greater. Lack of deceased donors because of cultural and religious factors has driven the use of living donors. Short-term survival has generally been good, but long-term outcomes have rarely been reported. In this article, we review the experience of 2 centers at opposite ends of the continent and share our experience of slightly different settings and show that success can be achieved even in resource-reduced environments.
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Results of orthotopic liver transplantation: a personal experience. 原位肝移植的结果：个人经验
The authors report on their experience of 158 liver transplants performed on 135 patients. Nineteen underwent re-transplantation and four of these required a second re-transplantation; total number of re-transplantations: 23 (14.6%). Hepatic cirrhosis was the most common indication (50.6%), of which alcoholic cirrhosis was the most common type (32.5%). The authors briefly report on their operative techniques and the results of their procedures. The operative mortality (30 days) was 13.3% (18 out of 135 patients). Complications included nine cases of hepatic artery thrombosis (5.7%), four of arterial stenosis (2.5%), one case of portal venous stenosis (0.63%), four cases of post-operative portal venous thrombosis (2.5%), seven of biliary fistula (4.4%; five following choledochocholedochostomy and two following choledochojejunostomy), and two cases of common bile duct stenosis (1.3%). The actuarial survival rate at 48 months is 80%.