肝移植4例报告

Liver transplantation:report of 4 cases

目的总结肝移植的临床经验。方法对4例男性患者施行肝移植,其中2例为经典式原位肝移植,另2例为背驮式原位肝移植,行肝移植的原因分别1例为肝炎后肝硬化、3例为肝炎后肝硬化合并原发性肝癌。术后免疫抑制剂采用甲基强的松龙、他克莫司及吗替麦考酚酯(骁悉),同时采用抗乙肝免疫球蛋白(抗-HBsAg)及拉米夫定预防乙肝病毒复发。结果4例均获治愈,已分别存活16个月、13个月、11个月和10个月。结论肝移植是治疗终末期肝病的最有效的治疗方法。适应证选择和手术时机的正确把握,围术期的严密监测、正确处理是保证肝移植患者存活的关键。

Objective To summarize the clinical experiences of liver transplantation. Methods All recipients were male. The indications included terminal livercirrhosis （lcase）, small hepatocellular carcinomas with cirrhosis （3 cases）. The blood types of recipients and donors were identical. The immunosuppressive protocols included methylprednisolone FK506 and Mycophenolate mofetil. Meanwhile intravenous antihepatitis B immunoglobulin and Lamivudine were used to prevent hepatitis B recurrence. Of the three patients,the first operation was standard orthotopic liver transplantation, the latter were the piggyback liver transplantation. Results All patients were cured. The longest survival of 16 months was found in 1 patient. Conclusion Liver transplantation can be employed for the recipients with end - stage liver disease as a conventional surgery. The end - stage liver diseases are the best indication for liver transplantation.