活体肝移植的供肝切取技术

The technique of donor hepatectomy for living-related liver transplantation

为缓解肝移植中的尸体供肝不足问题，探讨活体供肝移植的供肝切除方法。供者男4例，女4例，年龄19～46岁，平均33．1岁。其中5例切取肝脏Ⅱ、Ⅲ段，3例切取Ⅱ、Ⅲ、Ⅳ段。术中用B型超声波引导确定切肝界线，应用超声切割器切开肝实质，切肝过程不阻断肝脏血流，术中用自体血细胞回输装置收集出血并再利用。供者和受者均无手术死亡，术后经过顺利。研究结果提示成功的活体肝脏切取技术可为肝移植提供优质的供肝。

The technique of donor hepatectomy and outcome of the donors in 8 liver transplantation are reported. There were four female and 4 male donors with age ranging from 19~46years and mean age was 33. 1 years old. Left lateral segmentectomy (segment Ⅱ and Ⅲ ) were performed in 5 cases and left hepatic lobectomy (segment Ⅱ, Ⅲ and Ⅳ ) were performed in 3 cases. The line of parenchymal transaction was mapped by intraoperative ultrasound. The parenchymal resection was carried out with an ultrasound dissector in the absence of inflow vascular occlusion throughout the procedure. Cell-saver was used to collect blood lost during operation for autologous blood transfusion, but 1 case received 200ml homologous blood transfusion. Argon beam coagulator could assist hemostasis on large raw area. Fibrin glue was sprayed onto the cut surface of the liver in order to secure hemostasis and bile leakage. All the donors recovered well and are alive.