面试官: 为活体肝脏移植捐献肝脏. 这就是下一期《大发娱乐提供》.
播音员: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. 您正在收听的是范围.
面试官: So the problem is there are more people waiting for livers than there are deceased donors, but the solution is a procedure that allows a living person to donate part of their liver.
活体肝移植手术有多普遍?
Dr. 罗宾·金 is the Executive Medical Director of the Transplant Service Line at University Utah Health Care. 所以一个 活体肝移植这个过程有多普遍?
Dr. 金: The living donor liver transplant between one adult to another is not commonly done in North America. Perhaps 10 to 20% of all transplant centers in North America who perform transplants in adults have the ability to do adult-to-adult living donor liver transplantation. 面试官: The standard way of doing a liver donation is from somebody who is deceased and then you transplant that organ.
手术安全吗？?
Dr. 金: 是的, it's a cadaveric donor who donates their whole organ or part of their whole organ after they have passed away.
面试官: 这是一个相当安全的过程?
Dr. 金: 活体肝脏移植在技术上要求很高, 但它被认为在世界范围内被广泛接受. Parts of Asia where it is not in their culture to donate after being deceased, 他们几乎完全依靠活体肝脏移植. 大发娱乐从这些中心吸取了教训, 在北美，大发娱乐做得很好, 大发娱乐抓住机会互相学习, 这就是大发娱乐在犹他大学所做的.
活体肝移植的好处是什么?
面试官: 那么这种手术的优势是什么呢?
时间和可及性
Dr. 金: The great advantage of this procedure is we are able to offer life-saving transplantation to adults in a more timely fashion before these recipients get too sick or wait too long with their liver disease.
面试官: +, 有更多的人在等待肝脏和捐赠者, so if you can add some new people to that donation pool that has to help.
Dr. 金: 完全正确. The whole purpose of live donor liver transplantation is to get organs to folks who would normally not be able to get one, 从而扩大捐赠池.
它是如何工作的?
面试官: 简单地告诉我整个过程. 会发生什么?
Dr. 金: In a live donor liver transplant our primary goal is to advocate for 捐献者. 捐赠人必须自愿前来, 经过很长时间的评估, 给他们很多教育, 他们认为这是他们想做的事情.
Specifically, we have a person called an Independent Live Donor Advocate. The ILDA is a social worker that is tasked to make sure that they are there to protect 捐献者's best interests, 在任何给定的时间, if 捐献者 doesn't feel comfortable they can stop the procedure at any given time.
Essentially, the operation is two parallel operations which occur at the same time. In that day, 捐献者, under a surgery, donates a part of their liver. 在这种情况下, 如果是成人对成人, 通常是肝脏的右侧, 就在大厅对面的房间里, 在手术室里, 接受者将准备接受右侧肝脏, and thereby getting a good segment of liver which is sufficient for the overall function that the recipient needs. 更重要的是, 捐献者 will have enough excellent liver for them to survive without any problems.
肝脏真的会长回来吗?
面试官: 我知道肝脏实际上 . . . 这是唯一能在人体内再生的器官.
Dr. 金: 是的,绝对. The amazing thing about the adult liver is that within three months about 80 to 90% of the mass that was meant to be for that recipient will grow into place.
捐赠者复苏
面试官: 通常需要多长时间 捐献者 手术后恢复?
Dr. 金: A standard right liver operation to donate that part of the liver will require 捐献者 to be in the hospital perhaps one week. They can likely return to work within three to four weeks, but we ask them to wait a little longer. We just want to make sure that they're fully comfortable after the surgery to embark on any activities.
面试官: 这很神奇. 真的, that's not a lot of time considering that you just gave somebody else the gift of a few more years.
Dr. 金: 是的, and that's the incredible thing about the human body is it can heal so well.
供体的安全
面试官: 这个手术对捐赠者安全吗?
Dr. 金: 这个过程非常安全. 并发症的风险, 通常它们都是次要的, is 10%, 和其他同等规模的手术非常相似, 就死亡率而言，它非常低, 远低于1%. The programs that do it throughout the country have been highly scrutinized by UNOS, that governing body which determines who can and cannot do these procedures, and they've been prescreened and only given certification once it's been determined that they are the right program with the right quality results.
面试官: Is there going to be a time where it's going to be more commonly practiced at other institutions?
Dr. 金: I think that an institution has to be able to deliver and document excellent results. Then you have to have a scenario where the institution as well as the physicians and the healthcare providers all align together with a common mission to perform this fairly complex task. 一旦这一切都解决了，大发娱乐就可以继续了. But I have to say not a lot of programs throughout the country have that alignment.
面试官: 是的, 这就像一场完美风暴, 如果你愿意, 有能力的人, 有专业知识的人, 该设施, 他们能处理好, 这样的地方并不多见.
Dr. 金: 绝对. 犹他大学, we enjoy such a luxury of having that alignment that doesn't necessarily exist in other institutions.
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