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首页> 外文期刊>Transplantation: Official Journal of the Transplantation Society >Donor selection for adult-to-adult living donor liver transplantation: Well begun is half done
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Donor selection for adult-to-adult living donor liver transplantation: Well begun is half done

机译：成人到成人活体供肝移植的供体选择：良好的开端是成功的一半

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Background: Donor selection criteria for adult-to-adult living donor liver transplantation vary with the medical center of evaluation. Living donor evaluation uses considerable resources, and the nonmaturation of potential into actual donors may sometimes prove fatal for patients with end-stage liver disease. On the contrary, a thorough donor evaluation process is mandatory to ensure safe outcomes in otherwise healthy donors. We aimed to study the reasons for nonmaturation of potential right lobe liver donors at our transplant center. Methods: A retrospective data analysis of all potential living liver donors evaluated at our center from 1998 to 2010 was done. Results: Overall, 324 donors were evaluated for 219 potential recipients, and 171 (52.7%) donors were disqualified. Common reasons for donor nonmaturation included the following: (1) donor reluctance, 21%; (2) greater than 10% macro-vesicular steatosis, 16%; (3) assisted donor withdrawal, 14%; (4) inadequate remnant liver volume, 13%; and (5) psychosocial issues, 7%, and thrombophilia, 7%. Ten donors (6%) were turned down because of anatomic variations (8 biliary and 2 arterial anomalies). Donors older than 50 years and those with body mass index of more than 25 were less likely to be accepted for donation. Conclusions: We conclude that donor reluctance, hepatic steatosis, and assisted donor withdrawal are major reasons for nonmaturation of potential into actual donors. Anatomic variations and underlying medical conditions were not a major cause of donor rejection. A system in practice to recognize these factors early in the course of donor evaluation to improve the efficiency of the selection process and ensure donor safety is proposed.
机译：背景：成年至成年活体供肝移植的供体选择标准因医学评估中心而异。活体捐献者评估会使用大量资源，而潜在捐献者未成熟到实际捐献者中有时可能对晚期肝病患者致命。相反，必须进行全面的捐献者评估程序，以确保其他健康捐献者的安全结果。我们的目的是在我们的移植中心研究潜在右叶肝供体未成熟的原因。方法：对我中心1998年至2010年评估的所有潜在活体肝供体进行回顾性数据分析。结果：总共对324位捐赠者进行了219位潜在接受者的评估，而171位（52.7％）捐赠者被取消了资格。供体未成熟的常见原因包括：（1）供体不愿，21％; （2）大囊性脂肪变性大于10％，16％; （3）辅助捐赠者退出，占14％; （4）剩余肝脏量不足13％; （5）心理社会问题（7％）和血栓形成症（7％）。由于解剖变化（8个胆道异常和2个动脉异常），拒绝了10个捐献者（6％）。 50岁以上的捐赠者和体重指数大于25的捐赠者不太可能接受捐赠。结论：我们得出的结论是，捐助者的勉强，肝脂肪变性和辅助性的捐助者退缩是潜在的未成熟成为实际捐助者的主要原因。解剖结构变化和潜在的医学状况并不是捐赠者拒绝的主要原因。提出了一种在捐赠者评估过程中尽早识别这些因素的系统，以提高选择过程的效率并确保捐赠者的​​安全。

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