• 南京醫(yī)科大學(xué)第一附屬醫(yī)院肝臟外科,江蘇省肝臟移植中心(南京210029);

目的總結(jié)活體肝移植圍手術(shù)期處理的經(jīng)驗。方法對該院2001年1月至2002年12月完成的15例次(13例)活體肝移植圍手術(shù)期的處理情況進(jìn)行回顧性分析。 結(jié)果所有病例手術(shù)均獲成功。13例供體術(shù)后均順利康復(fù),除1例在手術(shù)后1個月因拔除T管發(fā)生膽瘺外,其余均未出現(xiàn)嚴(yán)重并發(fā)癥; 受體生存率為92.3%(12/13),已健康生存2個月~2年; 移植物存活率為86.7%(13/15)。1例成人肝豆?fàn)詈俗冃曰颊哂谛g(shù)后72 d死于不可逆轉(zhuǎn)的嚴(yán)重排斥反應(yīng)。術(shù)后并發(fā)肝動脈血栓形成2例,另1例再次行減體積肝移植,1例再次行全肝移植,均獲長期生存; 發(fā)生嚴(yán)重排斥反應(yīng)1例,ARDS 2例,細(xì)菌和(或)病毒感染6例,大量胸腔積液7例,膽瘺1例。結(jié)論圍手術(shù)期處理是活體肝移植術(shù)的關(guān)鍵之一,完善的圍手術(shù)期處理是肝移植成功的必要條件。

引用本文: 李國強,王學(xué)浩,李相成,張峰,錢建民,孔連寶,張浩,成峰,孫倍成. 活體肝移植圍手術(shù)期處理. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(4): 336-339. doi: 復(fù)制

1. Testa G, Malago M, Broelsch CE. From living related to insitu split liver transplantation: how to reduce waitinglist mortality [J]. Pediatr Transplant, 2001; 5(1)∶16.
2. 王學(xué)浩,杜競輝,張峰,等.活體供肝原位部分肝移植一例報告 [J]. 中華器官移植雜志, 1995; 16(3)∶133.
3. 李國強,王學(xué)浩.活體肝移植臨床研究的新進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2002; 9(4)∶279.
4. 王學(xué)浩,張峰,李相成,等.活體部分肝移植12例次臨床報告 [J]. 中華醫(yī)學(xué)雜志, 2002; 82(7)∶19.
5. 王學(xué)浩,李國強,李相成,等.活體肝移植手術(shù)經(jīng)驗回顧 [J]. 中國實用外科雜志, 2002; 22(6)∶89.
6. 王學(xué)浩,張峰,李相成,等.五例活體肝移植供體術(shù)后隨訪報告 [J]. 江蘇醫(yī)藥, 2001; 27(10)∶729.
7. Renz JF, Roberts JP. Longterm complications of living donor liver transplantation [J]. Liver Transpl, 2000; 6(6 Suppl 2)∶S73.
8. Grewal HP, Thistlewaite JR Jr, Loss GE, et al. Complications in 100 livingliver donors [J]. Ann Surg, 1998; 228(2)∶214.
9. Ikegami T, Kawasaki S, Hashikura Y, et al. An alternative method of arterial reconstruction after hepatic arterial thrombosis following livingrelated liver transplantation [J]. Transplantation,2000; 69(9)∶1953.
10. Hashikura Y, Kawasaki S, Terada M,et al. Longterm results of livingrelated donor liver graft transplantation: a singlecenter analysis of 110 transplants [J]. Transplantation, 2001; 72(1)∶95.
11. Tojimbara T, Fuchinoue S, Nakajima I, et al. Factors affecting survival after livingrelated liver transplantation [J]. Transpl Int, 2000; 13(Suppl 1)∶S136.
  1. 1. Testa G, Malago M, Broelsch CE. From living related to insitu split liver transplantation: how to reduce waitinglist mortality [J]. Pediatr Transplant, 2001; 5(1)∶16.
  2. 2. 王學(xué)浩,杜競輝,張峰,等.活體供肝原位部分肝移植一例報告 [J]. 中華器官移植雜志, 1995; 16(3)∶133.
  3. 3. 李國強,王學(xué)浩.活體肝移植臨床研究的新進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2002; 9(4)∶279.
  4. 4. 王學(xué)浩,張峰,李相成,等.活體部分肝移植12例次臨床報告 [J]. 中華醫(yī)學(xué)雜志, 2002; 82(7)∶19.
  5. 5. 王學(xué)浩,李國強,李相成,等.活體肝移植手術(shù)經(jīng)驗回顧 [J]. 中國實用外科雜志, 2002; 22(6)∶89.
  6. 6. 王學(xué)浩,張峰,李相成,等.五例活體肝移植供體術(shù)后隨訪報告 [J]. 江蘇醫(yī)藥, 2001; 27(10)∶729.
  7. 7. Renz JF, Roberts JP. Longterm complications of living donor liver transplantation [J]. Liver Transpl, 2000; 6(6 Suppl 2)∶S73.
  8. 8. Grewal HP, Thistlewaite JR Jr, Loss GE, et al. Complications in 100 livingliver donors [J]. Ann Surg, 1998; 228(2)∶214.
  9. 9. Ikegami T, Kawasaki S, Hashikura Y, et al. An alternative method of arterial reconstruction after hepatic arterial thrombosis following livingrelated liver transplantation [J]. Transplantation,2000; 69(9)∶1953.
  10. 10. Hashikura Y, Kawasaki S, Terada M,et al. Longterm results of livingrelated donor liver graft transplantation: a singlecenter analysis of 110 transplants [J]. Transplantation, 2001; 72(1)∶95.
  11. 11. Tojimbara T, Fuchinoue S, Nakajima I, et al. Factors affecting survival after livingrelated liver transplantation [J]. Transpl Int, 2000; 13(Suppl 1)∶S136.