同种异体肝移植供肝灌注不理想时的补救措施

Remedition of Unsatisfied Perfusion on Liver Transplantation from Cardiac Arrest Homogeneity Donors.

目的探讨在心脏停搏同种异体供体肝移植获取中灌注不理想时的补救措施及其临床意义。方法对2001年和2004年杭州市第一人民医院开展完成的人原位肝移植的资料进行回顾性分析,2例供肝的最初灌注由于多方面原因均未达到满意的要求,及时通过门静脉灌注的补救措施,冲洗出其内的血凝块或红细胞等直至流出道清亮。结果 2例供肝虽经历心脏停搏和灌注不理想等情况,但及时补救,2例供肝移植后肝功能无明显损害,肝细胞穿刺病检未见不可逆转变化,患者分别随访4年余和20个月至今均存活,生活质量良好。结论供肝最初灌注不理想时,及时采取适宜速度和压力门静脉灌洗不仅可以减轻对供肝在灌洗这一环节的损伤,又能保证供肝充分的灌洗,对减少供肝质量的损失和提高此类肝移植术后的存活率十分必要。

Objective To sum up the clinical sigoificantion and remedition of unsatisfied perfusion on liver transplantation from cardiac arrest homogeneity donors, Methods Retrospective analysis of data of two cases about human original site liver transplantation was conducted at first people＇ s hospital of Hangzhou in 2001 and 2004. Two case, perfused unsatisfied at first because of various factors. so we adopted some remedifion such as reperfusion from portal vein till fluid UW liquid clear without any red blood cell or little gore. Results Liver function of donor recovered well postoperation and no unreversed changes by biopsy, the patient followed up for about 4 years and 20 months respectively and all in good life. Conclusions Optimal speed and reperfusionalpressure through portal vein would alleviate the reperfusional injury in liver transplantation from cardiac arrest donors and reperfusion unsatisfacted at firsy, and thus reduce the loss of liver quality and raise the survival rate thereby.