Camino Valentin-Gamazo, Georgios C. Sotiropoulos, Silvio Nadalin, Massimo Malago, Christoph E. Broelsch. 综合、内脏及移植外科，埃森大学医院，埃森，德国

活体肝移植（LDLT）对终末期肝病患者有良好的治疗效果。目前在德国，由于尸体肝脏器官的短缺，等候移植名单上的患者的等待时间长于18个月，死亡率也逐年增加。在该研究中，我们对在我院考虑做活体肝移植的全部患者进行了效果评估。

从1998 年4月至2006年11月，我院共有587例患者考虑活体肝移植（儿童68例，成人519例）。 189例患者（32%）移植了合适的肝脏。对203例（35%）供体的评估不完全，主要是因为受体病情的不同，比如优先考虑活体肝移植、受体死亡、受体病情过重无法进行活体肝移植、进行性肿瘤等。195例（33%）没有找到合适的活体供者。除了上述患者之外，73例接受尸体肝移植，23例等候患者在移植前死亡，20例因进行性肿瘤而退出等候名单，49例不能被包含在名单之内（24例肿瘤分期和25例外国人）。

只有少数考虑原位肝移植的患者才能施行活体肝移植术。活体供者的当选可能性将限制活体肝移植的应用。进一步了解文化的差异，了解人们为何自愿参加评估的激发因子将有助于提高尸体器官供者和活体供者的移植率。

Outcome of Patients Considered for Living Donor Liver Transplantation
Camino Valentin-Gamazo, Georgios C. Sotiropoulos, Silvio Nadalin, Massimo Malago, Christoph E. Broelsch. General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany

Living donor liver transplantation (LDLT) has developed as an effective therapy for selected patients with end stage liver disease. In Germany at present, due to the shortage of cadaveric organ livers, time on the waiting list for liver transplantation is longer than 18 months and mortality on the waiting list is increasing every year. In the present study, we evaluate the outcome of all patients considered for LDLT at our institution.

From April 1998 to November 2006 a total of 587 patients (68 children and 519 adults) were considered for LDLT at our institution. 189 (32%) patients were transplanted with suitable living donors. In 203 (35%) cases the evaluation of donors was not completed due to change in recipient status (cadaveric liver transplantation prior to LDLT, recipient death, recipient becoming too sick for LDLT or tumor progression). In 195 (33%) cases no suitable living donor was found. Out of them, 73 patients were transplanted with a cadaveric organ, 23 died on the waiting list before transplantation, 20 patients are still on the waiting list, 30 patients were dropped out of the list because of tumor progression and 49 patients could not be listed (24 because of tumor stage, 25 foreigners).

Only a minority of patients considered for orthotopic liver transplantation will lead to LDLT. The availability of suitable living donors may limit the application of LDLT. Further understanding of the cultural differences, as well as motivating factors, for why people volunteer for evaluation, may help to improve cadaveric and living donor transplant rates.

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