【摘要】目的 探討肝移植時(shí)脾切除的適應(yīng)證及對(duì)肝移植預(yù)后的影響。方法 回顧性分析我院2001年1月至2006年4月期間施行的260例背馱式肝移植，肝移植時(shí)行脾切除者共28例（脾切除組），按1∶2的比例隨機(jī)抽取同期肝移植時(shí)未行脾切除者56例作為對(duì)照組，對(duì)比分析2組間的感染率、1年存活率及急性排斥反應(yīng)發(fā)生率。結(jié)果 脾切除組的感染率高于對(duì)照組（85.7% vs 55.4%，P＜0.05），急性排斥反應(yīng)發(fā)生率和1年存活率均明顯低于對(duì)照組（3.6% vs 14.3%，P＜0.05; 46.4% vs 82.1%，P＜0.05）。結(jié)論 脾切除增加肝移植術(shù)后的感染率和死亡率，除非有明確的適應(yīng)證，肝移植時(shí)不宜行脾切除。
引用本文： 葉啟發(fā),佘興國(guó),明英姿,成柯,馬穎,牛英,任祖海,劉斌,趙于軍. 脾切除對(duì)肝移植預(yù)后影響的回顧性探討. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(3): 158-161. doi: 復(fù)制
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- 1. 9 Kita Y, Harihara Y, Hirata M, et al. Splenectomy for idiopathic thrombocytopenic purpura after living-related liver transplantation [Ｊ] . Transplantation, 2000; 70(3) ∶ 553.
- 2. 王偉林, 高磊, 梁廷波, 等. 脾切除對(duì)肝移植患者的影響 [Ｊ]. 中華醫(yī)學(xué)雜志, 2006; 86(18)∶1240.
- 3. Cescon M, Sugawara Y, Takayama T, et al. Role of splenectomy in living-donor liver transplantation for adults [Ｊ]. Hepatogastroenterology, 2002; 49(45)∶721.
- 4. 葉啟發(fā)， 陳知水， 曾凡軍, 等. 50例次背馱式肝移植技術(shù)回顧分析 [Ｊ]. 中華器官移植雜志， 2001; 22(5)∶282.
- 5. Austyn JM, Kupiec-Weglinski JW, Hankins DF, et al. Migration patterns of dendritic cells in the mouse. Homing to T cell-dependent areas of spleen, and binding within marginal zone [Ｊ]. J Exp Med, 1988; 167(2)∶646.
- 6. Troisi R, Colle I, Van Vlierberghe H, et al. Splenectomy and liver transplantation [Ｊ]. Transplant Proc, 2001; 33(1-2)∶1500.
- 7. Neumann UP, Langrehr JM, Kaisers U, et al. Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after liver transplantation [Ｊ]. Transpl Int, 2002; 15(5)∶226.
- 8. Samimi F, Irish WD, Eghtesad B, et al. Role of splenectomy in human liver transplantation under modern-day immunosuppression [Ｊ]. Dig Dis Sci, 1998; 43(9)∶1931.
- 9. Nagappan K, David G, Paul M, et al. Splenectomy and liver transplantation:outcome and sepsis-related mortality [Ｊ]. Transplantation, 1999； 67(9)∶S633.