小儿亲体部分肝移植的手术要点探讨

Exploration of Critical Technical Problem of Children' Partial Liver Grafting Provided by Parental Donors

目的探讨小儿亲体部分肝移植的手术技术要点。方法对2例肝功能衰竭患儿进行亲体部分肝移植术,供体分别为患儿的母亲和父亲。手术分别切取供体的右半肝和左外侧叶。受体行保留下腔静脉的全肝切除术,然后将供肝进行原位移植。 结果两例患儿分别移植肝重565克和329克,供体和受体术后已经分别随访5.5个月和6.5个月,均无并发症健康生活。受体未发生肝静脉、门静脉、肝动脉和胆管吻合口的并发症。结论亲体肝移植是治疗小儿终末期肝病的有效方法,术前准确的血管影像学检查,严格的围手术期管理特别是精确的手术技术是小儿亲体肝移植成功的关键。

Objective To explore the critical technical problem of childrens pratial liver grafting provided by parental donors. Methods Partial liver grafting was corned out in 2 cases of hepatic failure.Donors of grafting liver were the ill childrens father and mather,respeatively.The one half right liver and a lateral lobe of left liver of donors were drew out by operation res-pertively.The two recipient's whole liver were resected respectively under keeped their inferion vena cave,then the donors' partial liver were grafted into respectively the two recipients by ortho-topic transplantation model. Results The wigth of grafted liver from two donors were 565g and 329g respectively.The donors and recipients of partial liver grafting after the operation was followed up for 5.5 months and 6.5 months respectively.In the liver vena, portae vena liver artery and cholanastomatic orifice etc.complications were no occurred. Conclusions Based on the data, we consider that the parental liver grafting is an effective method to treat the children with terminal phase liver diseases.Angography examination,strict management of perioperation,specificallyin accurate operative skill are successful keys.