• 四川大學(xué)華西醫(yī)院普外科(成都610041);

目的報(bào)道筆者利用尸體下腔靜脈(IVC)替代受體肝后IVC施行成人間活體肝移植(LDLT)治療布加綜合征(BCS)并IVC狹窄的經(jīng)驗(yàn)。
方法1例35歲男性BCS并肝后IVC狹窄的患者，曾接受內(nèi)科治療，并于9個(gè)月前經(jīng)放射介入置入金屬擴(kuò)張器，但癥狀無緩解。最終患者被施行了成人間LDLT，術(shù)中采用了尸體IVC替代受體肝后IVC進(jìn)行重建。
結(jié)果患者術(shù)后過程平穩(wěn)，效果滿意。
結(jié)論筆者認(rèn)為采用LDLT及利用尸肝IVC重建受者肝后IVC治療BCS并肝后IVC狹窄的術(shù)式可推薦作為一種新的術(shù)式。

引用本文： 嚴(yán)律南,李波,曾勇,文天夫,趙紀(jì)春,徐明清,王文濤,楊家印,馬玉奎,吳泓,陳哲宇,潘光棟. 活體肝移植治療布加綜合征并下腔靜脈狹窄. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(1): 82-84下轉(zhuǎn)88. doi: 復(fù)制

1. Putnam CW, Porter KA, Weil R 3rd, et al. Liver transplantation of BuddChiari syndrome [Ｊ]. JAMA, 1976; 236(10)∶1142.
2. Wang ZG, Jones RS. BuddChiari syndrome [Ｊ]. Curr Probl Surg, 1996; 33(2)∶83.
3. Melear JM, Goldstein RM, Levy MF, et al. Hematologic aspects of liver transplantation for BuddChiari syndrome with special reference to myeloproliferative disorders [Ｊ]. Transplantation, 2002; 74(8)∶1090.
4. Orloff MJ, Daily PO, Orloff SL, et al. A 27year experience with surgical treatment of BuddChiari syndrome [Ｊ]. Ann Surg, 2000; 232(3)∶340.
5. Slakey DP, Klein AS, Venbrux AC, et al. BuddChiari syndrome: current management options [Ｊ]. Ann Surg, 2001; 233(4)∶522.
6. Srinivasan P, Rela M, Prachalias A, et al. Liver transplantation for BuddChiari syndrome [Ｊ]. Transplantation, 2002; 73(6)∶973.
7. Shaked A, Goldstein RM, Klintmalm GB, et al. Portosystemic shunt versus orthotopic liver transplantation for the BuddChiari syndrome [Ｊ]. Surg Gynecol Obstet, 1992; 174(6)∶453.
8. Bismuth H, Sherlock DJ. Portasystemic shunting versus liver transplantation for the BuddChiari syndrome [Ｊ]. Ann Surg, 1991; 214(5)∶581.
9. Nezakatgoo N, MalekHosseini SA, Salahi H, et al. Lessons learned from the first successful livingrelated liver transplantation [Ｊ]. Transplant Proc, 1999; 31(8)∶3171.
10. Haberal M, Karakayali H, Boyacioglu S, et al. Successful livingrelated heterotopic auxiliary liver transplantation for chronic BuddChiari syndrome [Ｊ]. Transplant Proc, 1999; 31(7)∶2902.
11. Yasutomi M, Egawa H, Kobayashi Y, et al. Living donor liver transplantation for BuddChiari syndrome with inferior vena cava obstruction and associated antiphospholipid antibody syndrome [Ｊ]. J Pediatr Surg, 2001; 36(4)∶659.
12. 嚴(yán)律南, 文天夫, 李波, 等. 成人成人活體肝移植一例報(bào)告 [Ｊ]. 中華肝膽外科雜志, 2002; 8(10)∶634.
13. Harms J, Bartels M, Bourquain H, et al. Computerized CTbased 3D visualization technique in living related liver transplantation [Ｊ]. Transplant Proc, 2005; 37(2)∶1059.
14. Tanaka K, Ogura Y. “Smallforsize graft” and “smallforsize syndrome” in living donor liver transplantation [Ｊ]. Yonsei Med J， 2004; 45(6)∶1089.
15. Oya H, Sato Y, Yamamoto S, et al. Surgical procedures for decompression of excessive shear stress in smallforsize living donor liver transplantation——new hepatic vein reconstruction [Ｊ]. Transplant Proc, 2005; 37(2)∶1108.
16. TuttleNewhall JE, Collins BH, Desai DM, et al. The current status of living donor liver transplantation [Ｊ]. Curr Probl Surg, 2005; 42(3)∶14417Curran C. Adulttoadult living donor liver transplantation: history, current practice, and implications for the future [Ｊ]. Prog Transplant, 2005; 15(1)∶36.
17. Langer B, Stone RM, Colapinto RF, et al. Clinical spectrum of the BuddChiari syndrome and its surgical management [Ｊ]. Am J Surg, 1975; 129(2)∶137.
18. Terabayashi H, Okuda K, Nomura F, et al. Transformation of inferior vena caval thrombosis to membranous obstruction in a patient with the lupus anticoagulant [Ｊ]. Gastroenterology, 1986; 91(1)∶219.
19. Shaked A, Goldstein R. Transplantation for BuddChiari syndrome [A]. In Busuttil RW, Klintmalm GB(eds). Transplantation of the liver [M]. Philadelphia: Saunders, 1996∶138-144.
20. Halff G, Todo S, Tzakis AG, et al. Liver transplantation for the BuddChiari syndrome [Ｊ]. Ann Surg, 1990; 211(1)∶43.
21. Faust TW. BuddChiari syndrome [Ｊ]. Curr Treat Options Gastroenterol, 1999; 2(6)∶491.
22. Martin LG, Henderson JM, Millikan WJ Jr, et al. Angioplasty for longterm treatment of patients with BuddChiari syndrome [Ｊ]. AJR Am J Roentgenol, 1990; 154(5)∶1007.
23. Kugelmas M. BuddChiari syndrome. Treatment options and the value of liver transplantation [Ｊ]. Hepatogastroenterology, 1998; 45(23)∶1381.
24. Yan LN, Wang W, Li B, et al. Venovenous bypass ahead of mobilization of the liver in orthotopic liver transplantation [Ｊ]. Hepatobiliary Pancreat Dis Int, 2003; 2(1)∶44.
  1. 1. Putnam CW, Porter KA, Weil R 3rd, et al. Liver transplantation of BuddChiari syndrome [Ｊ]. JAMA, 1976; 236(10)∶1142.
  2. 2. Wang ZG, Jones RS. BuddChiari syndrome [Ｊ]. Curr Probl Surg, 1996; 33(2)∶83.
  3. 3. Melear JM, Goldstein RM, Levy MF, et al. Hematologic aspects of liver transplantation for BuddChiari syndrome with special reference to myeloproliferative disorders [Ｊ]. Transplantation, 2002; 74(8)∶1090.
  4. 4. Orloff MJ, Daily PO, Orloff SL, et al. A 27year experience with surgical treatment of BuddChiari syndrome [Ｊ]. Ann Surg, 2000; 232(3)∶340.
  5. 5. Slakey DP, Klein AS, Venbrux AC, et al. BuddChiari syndrome: current management options [Ｊ]. Ann Surg, 2001; 233(4)∶522.
  6. 6. Srinivasan P, Rela M, Prachalias A, et al. Liver transplantation for BuddChiari syndrome [Ｊ]. Transplantation, 2002; 73(6)∶973.
  7. 7. Shaked A, Goldstein RM, Klintmalm GB, et al. Portosystemic shunt versus orthotopic liver transplantation for the BuddChiari syndrome [Ｊ]. Surg Gynecol Obstet, 1992; 174(6)∶453.
  8. 8. Bismuth H, Sherlock DJ. Portasystemic shunting versus liver transplantation for the BuddChiari syndrome [Ｊ]. Ann Surg, 1991; 214(5)∶581.
  9. 9. Nezakatgoo N, MalekHosseini SA, Salahi H, et al. Lessons learned from the first successful livingrelated liver transplantation [Ｊ]. Transplant Proc, 1999; 31(8)∶3171.
  10. 10. Haberal M, Karakayali H, Boyacioglu S, et al. Successful livingrelated heterotopic auxiliary liver transplantation for chronic BuddChiari syndrome [Ｊ]. Transplant Proc, 1999; 31(7)∶2902.
  11. 11. Yasutomi M, Egawa H, Kobayashi Y, et al. Living donor liver transplantation for BuddChiari syndrome with inferior vena cava obstruction and associated antiphospholipid antibody syndrome [Ｊ]. J Pediatr Surg, 2001; 36(4)∶659.
  12. 12. 嚴(yán)律南, 文天夫, 李波, 等. 成人成人活體肝移植一例報(bào)告 [Ｊ]. 中華肝膽外科雜志, 2002; 8(10)∶634.
  13. 13. Harms J, Bartels M, Bourquain H, et al. Computerized CTbased 3D visualization technique in living related liver transplantation [Ｊ]. Transplant Proc, 2005; 37(2)∶1059.
  14. 14. Tanaka K, Ogura Y. “Smallforsize graft” and “smallforsize syndrome” in living donor liver transplantation [Ｊ]. Yonsei Med J， 2004; 45(6)∶1089.
  15. 15. Oya H, Sato Y, Yamamoto S, et al. Surgical procedures for decompression of excessive shear stress in smallforsize living donor liver transplantation——new hepatic vein reconstruction [Ｊ]. Transplant Proc, 2005; 37(2)∶1108.
  16. 16. TuttleNewhall JE, Collins BH, Desai DM, et al. The current status of living donor liver transplantation [Ｊ]. Curr Probl Surg, 2005; 42(3)∶14417Curran C. Adulttoadult living donor liver transplantation: history, current practice, and implications for the future [Ｊ]. Prog Transplant, 2005; 15(1)∶36.
  17. 17. Langer B, Stone RM, Colapinto RF, et al. Clinical spectrum of the BuddChiari syndrome and its surgical management [Ｊ]. Am J Surg, 1975; 129(2)∶137.
  18. 18. Terabayashi H, Okuda K, Nomura F, et al. Transformation of inferior vena caval thrombosis to membranous obstruction in a patient with the lupus anticoagulant [Ｊ]. Gastroenterology, 1986; 91(1)∶219.
  19. 19. Shaked A, Goldstein R. Transplantation for BuddChiari syndrome [A]. In Busuttil RW, Klintmalm GB(eds). Transplantation of the liver [M]. Philadelphia: Saunders, 1996∶138-144.
  20. 20. Halff G, Todo S, Tzakis AG, et al. Liver transplantation for the BuddChiari syndrome [Ｊ]. Ann Surg, 1990; 211(1)∶43.
  21. 21. Faust TW. BuddChiari syndrome [Ｊ]. Curr Treat Options Gastroenterol, 1999; 2(6)∶491.
  22. 22. Martin LG, Henderson JM, Millikan WJ Jr, et al. Angioplasty for longterm treatment of patients with BuddChiari syndrome [Ｊ]. AJR Am J Roentgenol, 1990; 154(5)∶1007.
  23. 23. Kugelmas M. BuddChiari syndrome. Treatment options and the value of liver transplantation [Ｊ]. Hepatogastroenterology, 1998; 45(23)∶1381.
  24. 24. Yan LN, Wang W, Li B, et al. Venovenous bypass ahead of mobilization of the liver in orthotopic liver transplantation [Ｊ]. Hepatobiliary Pancreat Dis Int, 2003; 2(1)∶44.