ABSTRACT
Colorectal cancer is one of the common malignant tumors in China. Studies have shown that more than 50% of patients with colorectal cancer will experience metastasis. After systematic treatment, patients with resectable colorectal cancer could obtain favorable 5-year survival rate. However, patients with unresectable colorectal liver metastasis constantly obtain poor prognosis. In spite of the development of medical treatment, patients with unresectable colorectal liver metastasis can be treated by multiple approaches, such as interventional therapy combined with targeted therapy and immunotherapy, clinical efficacy is relatively low. Hence, clinicians divert extensive attention to liver transplantation. Liver transplantation, as an emerging treatment in recent years, is expected to improve clinical prognosis of patients with unresectable colorectal liver metastasis. In this article, research progress in liver transplantation for patients with unresectable colorectal liver metastasis was reviewed, mainly including the historical overview, recent results, prognostic factors, adaptation criteria, relationship with systemic treatment, liver source shortage and donor allocation, aiming to provide reference for liver transplantation for patients with colorectal liver metastasis.
ABSTRACT
Along with the development of liver transplant techniques, clinical efficacy of liver transplantation has been significantly improved, and the survival of the recipients and liver grafts has been remarkably prolonged. However, the source of organ donation after citizen' s death still fails to meet the requirement of liver transplantation. The shortage of donor liver limits further development of liver transplantation. In recent years, living donor liver transplantation has been widely used in the treatment of patients with end-stage liver disease as one of the means to resolve organ shortage. As a special type of living donor liver transplantation, right posterior segmental graft liver transplantation provides a novel solution for expanding the potential donor pool for living donor liver transplantation. In this article, the development profile of living donor liver transplantation, donor selection of right posterior segmental graft for living donor liver transplantation, anatomical challenges of right posterior segmental graft procurement and surgical skills of right posterior segmental graft procurement were reviewed. Moreover, the prospect of right posterior segmental graft for living donor liver transplantation was predicted, aiming to promote the development of liver transplantation in clinical practice and bring benefits to more patients with end-stage liver diseases.
ABSTRACT
Lung transplantation is the only effective treatment of end-stage lung diseases. Nevertheless, shortage of donor lungs has become increasingly prominent worldwide. A large quantity of patients died while waiting for lung transplantation. Urgent lung transplantation is a prioritized allocation strategy for donor lung transplantation according to the urgency of diseases, aiming to shorten the waiting time for donor lungs and reduce the fatality of patients on the waiting list for lung transplantation. However, no consensus has been reached worldwide on the definition, criteria and application of the terminology of urgent lung transplantation. In addition, the survival and net benefits of lung transplant recipients based on this allocation system are still controversial. On the basis of previous clinical research on urgent lung transplantation, the definition criteria, risk factors, survival outcomes, limitations and optimization measures were explicitly elucidated in this article, aiming to provide theoretical reference for comprehensive evaluation of the feasibility of urgent lung transplantation and further optimizing the allocation system of donor lungs.