肝移植中血管异常时的血管重建

Vascular reconstruction of vascular abnormalities in orthotopic liver transplantation

目的 :探讨肝移植过程中血管异常时血管重建的方式和方法。方法 :对 16例肝移植的供肝动脉变异、受体肝动脉异常和受体门静脉血栓形成采用了多种方法进行重建 ,术后采用彩色多普勒超声检查的方法监测重建血管的通畅情况。结果 :肝移植术后 ,14例重建的血管通畅良好 ,生存正常 ;1例术后7d发生门静脉血栓形成 ,并于术后 4周死于消化道大出血 ;1例术后 7d死于药物引起的严重的血管内溶血 ,但重建血管通畅良好。结论

Objective:To explore the techniques of vascular reconstruction in hepatic arterial and portal venous abnormalities during orthotopic liver transplantation.Methods:The alternative vascular reconstruction techniques were introduced for 16 cases with hepatic vascular abnormalities which included donor’s hepatic arterial anomalism,recipient hepatic artery abnormalities and recipient portal thrombosis.Duplex was introduced to observe the patency of reconstructive vessels postoperatively.Results:The reconstructive vessels were patent in 14 cases.Portal thrombosis occurred in 1 case who died of upper gastrointestinal bleeding at the 4th postoperative week.One case died of severe intravascular hemolysis due to some drugs,although the reconstructive artery was patent.Conclusion:Achieving the success of liver transplantation,it is very important that proper and alternative techniques of hepatic vascular reconstruction are chosen on the principle of vascular reconstruction on vascular abnormalities.