臨床外科75巻9号

2020年09月発行

特集 変貌する肝移植—適応拡大・ドナー選択・治療戦略の最先端を知る 原疾患の治療と今後の展開

アルコール性肝硬変およびNASHに対する肝移植

著者： 戸島剛男¹ 吉住朋晴¹ 原田昇¹ 伊藤心二¹ 森正樹¹

所属機関： ¹九州大学大学院消化器・総合外科

ページ範囲：P.1068 - P.1073

【ポイント】
◆アルコール性肝硬変に対する肝移植では，十分な断酒期間をおいた症例において移植後成績は良好であり，再飲酒の回避と術後de novo悪性疾患の早期発見が重要と考えられる．
◆NASHに対する肝移植は食生活の欧米化に起因して増加傾向にあるが，術後のNASH再発や合併症，予後について欧米と異なる可能性もあり，今後も厳重な観察が必要である．
◆肝移植は，脳死・生体いずれにおいてもドナーの尊い意思により成立する医療であり，術後成績を鑑みながらアルコール性肝硬変・NASHそれぞれの適応に関しては今後も十分に議論される必要がある．

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