引用本文:赖彦华,何俊鑫,庞飞雄,黄晓春,欧升淞,韦小娇,徐钰驹,李甲志,韦光立,龙诗彬,刘晓缅,杨建荣.原位劈离式肝移植单中心经验[J].中国临床新医学,2020,13(12):1204-1207.
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原位劈离式肝移植单中心经验
赖彦华,何俊鑫,庞飞雄,黄晓春,欧升淞,韦小娇,徐钰驹,李甲志,韦光立,龙诗彬,刘晓缅,杨建荣
530021 南宁,广西壮族自治区人民医院移植科,广西门静脉高压防治研究重点实验室
摘要:
[摘要] 目的 探讨公民逝世后器官捐献原位劈离式肝移植(ISSLT)的临床疗效及其安全性。方法 回顾性分析该院2019-12~2020-11实施的7例ISSLT供者、受者资料。7例供者均为中国Ⅰ类器官捐献,中位年龄33岁,主要诊断为脑出血5例,脑外伤2例。ICU住院时间为(3.4±2.5)d。经严格评估后其中5例行在体肝劈离并获得10例具有独立解剖功能的肝段。2例因门静脉解剖变异而放弃劈离,行劈离的5例ISSLT中,均为成人-儿童组合。该移植中心受者肝移植手术病例右侧肝叶采用经典肝移植手术,左侧肝叶采用背驼式肝移植手术方式。结果 10例受者中,手术时间为(394±58)min,出血量为1 600(100~3 000)ml。截至2020-11,受者中位随访时间为6个月,均未出现出血以及血管、胆道、腹腔感染等严重并发症。结论 ISSLT可以在经过严格评估后的脑死亡供体中安全开展,术后疗效良好,提高了供肝的使用率。
关键词:  肝移植  原位劈离  脑死亡器官捐献
DOI:10.3969/j.issn.1674-3806.2020.12.05
分类号:R 657.3
基金项目:广西医疗卫生适宜技术开发与推广应用项目(编号:S2018086)
In situ split liver transplantation: a single-center experience
LAI Yan-hua, HE Jun-xin, PANG Fei-xiong, et al.
Department of Organ Transplantation, the People′s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Prevention and Treatment of Portal Hypertension, Nanning 530021, China
Abstract:
[Abstract] Objective To investigate the clinical efficacy and safety of in situ split liver transplantation(ISSLT) with organ donation after the death of citizens. Methods The data of 7 cases of ISSLT donors and recipients undergoing the operation in the People′s Hospital of Guangxi Zhuang Autonomous Region from December 2019 to November 2020 were retrospectively analyzed. Seven donors were Chinese Class Ⅰ organ donors, including principal diagnosis of cerebral haemorrhage in 5 cases and traumatic brain injury in 2 cases, and their median age was 33 years. The length of stay in Intensive Care Unit(ICU) was (3.4±2.5)days. After strict evaluation, 5 out of 7 cases underwent in vivo liver splitting and 10 liver segments with independent anatomical function were obtained. Two patients gave up splitting because of anatomic variation of portal vein, and 5 cases undergoing ISSLT were all adult-child pairing. The right hepatic lobe of the liver transplantation cases in our transplantation centre were performed using the classical liver transplantation and the left hepatic lobe using the dorsal camelid liver transplantation approach. Results Of the 10 recipients, the operation time was (394±58)min and the blood loss was 1 600(100~3 000)ml. As of November 2020, the median follow-up time of the recipients was 6 months, and there were no severe complications such as bleeding, biliary tract and abdominal infection and vascular complications. Conclusion ISSLT can be safely performed in brain-dead donors after rigorous evaluation, with good postoperative outcomes and improved utilization rate of donor livers.
Key words:  Liver transplantation  In situ split  Donation after brain death