■綜説
本邦における生体肝移植
谷合 信彦, 秋丸 琥甫, 吉田 寛, 田尻 孝
日本医科大学大学院医学研究科臓器病態制御外科学
Living Donor Liver Transplantation in Japan
Nobuhiko Taniai, Koho Akimaru, Hiroshi Yoshida and Takashi Tajiri
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Twenty years have passed since the first case of living donor liver transplantation (LDLT) in Japan. The recipients of LDLT have rapidly changed from children to adults through the use of right lobe grafts. The number of LDLTs in Japan has increased since January 2004 because of indication for LDLT changed widely in an insurance application. (UNCLEAR) A total of 4,292 LDLTs have been performed as of December 31, 2006, and 2,621 (61.1%) of these have been adult-to-adult LDLTs. Patients who have hepatocellular disease or hepatocellular carcinoma or both account for more than 50% of all recipients in Japan. The overall 3-, 5- and 10-year survival rates were 73.8%, 70.4%, and 66.3%, respectively. There were no significant differences in survival rates between LDLT in Japan and cadaveric transplantation in America or Europe. The survival rates will improve to clarify the timing and indications for LDLT and the optimal operative procedures. However, because of the number of patients requiring transplant will increase, it is important that cadaveric donor liver transplant is promoted in addition to LDLT in Japan.
日医大医会誌 2009; 5(1), 13-21
Key words
living donor liver transplantation, hepatocellular carcinoma, hepatitis B or C cirrhosis, indication and timing of liver transplantation, hepatic vein reconstruction
Correspondence to
Nobuhiko Taniai, MD, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：Taniain@nms.ac.jp
受付：2008年9月1日 受理：2008年10月17日 |
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