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页数:11页
时间:2019-02-04
《Chapter 27 – Liver Transplantation》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、CHAPTER27LIVERTRANSPLANTATIONNancyL.AscherThefirsthumanlivertransplantationwasperformedinhistory1963byDr.ThomasStarzl.Thepatientsufferedfrombiliaryindicationsandcontraindications3atresia,hadcoagulopathy,anddidnotsurvivethesurgery.livedonorlivertransplantationAdditionalattemptsinBerlin,Bo
2、ston,andPariswerealsotechnicalaspectsunsuccessful.Subsequentinitialsuccessesinorthotopicliverearlycomplicationstransplantationwereinpatientswithlivercancer.Thesepatientsextendedcriteriadonorshadlessportalhypertensionandrelativelystraightforwardevaluationofabnormalliverfunctiontestresults
3、surgerybutwerenotlong-termsurvivorssecondarytorecur-immunosuppressionafterlivertransplantationrentdisease,technicalproblems,andlackofadequateretransplantationandrecurrentdiseaseimmunosuppression.Intheearly1980s,livertransplantationintheUnitedroleoflivertransplantationforhepatocellularSta
4、teswaslimitedtoahandfulofprograms;initialresultswerecarcinomapoor,withlessthan30%1-yearsurvival.Amajoradvancecameroleofcellulartransplantationinliverreplacementwiththeclinicalintroductionofcyclosporineforimmunosup-4pressioninsolidorgantransplantation.Itsuseinlivertrans-plantrecipientsall
5、owedforfurtherdevelopmentsinthisfield.Assuccessinlivertransplantationincreased,morecentersHISTORYinitiatedprogramsandincreasingnumbersofpatientsavailedTheabilitytoreplacethehumanliversuccessfullyreflectsthethemselvesofthistherapy.Inattemptstoprovidetimelytrans-richhistoryoftransplantatio
6、n.Transplantationmovedbeyondplantationtopatientswiththegreatestneed,localregionalandtheexchangeofskinandtissuewiththedevelopmentofvascularnationaldistributionschemesweredevelopedandallocationtotechniques.Sewingbloodvesselstogether,asdescribedbyAlexispatientsonthewaitinglistbecamebasedonn
7、eedratherthanCarrelattheoutsetofthe20thcentury,madeitpossibleforontimeonthelist(seelater,“OrganShortage,ModelforEnd-researcherstoimplantwholeorgansforthefirsttime.ThisStageLiverDisease,andLiverDistribution”).developmentsetthestagefortheimplantationoforgansintoTheincreasin
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