七例八次背驮式原位肝移植

Piggyback orthotopic liver transplantation in 4 patients with Wilson disease and 3 with advanced liver diseases

对４例Ｗｉｌｓｏｎ病及３例晚期肝病患者施行了８次背驮式原位肝移植术，其中１例为减体积性背驮式原位肝移植。３例已分别存活２年、９个月、６个月，４例死于术后并发症。认为代谢性疾病是原位肝移植的最佳适应证，其次是肝硬变；术后感染、急性和慢性排斥、肺部并发症及胆道并发症是影响患者存活的重要因素；背驮式原位肝移植对全身血流动力学的影响较小。

Piggyback orthotopic liver transplantation (OLT) (8 times) was performed in 4 patients with Wilson disease and 3 with advanced liver diseases. Of 7 patients, 6 cases (7 times) received piggyback OLT with whole liver, 1 piggyback OLT with reducedsize grafts of right hepatic lobe. Three cases have survived 2 years, 9 months and 4 months, respectively. Four cases died of postoperative complications. It was considered that metabolic disease was the best indications for OLT, then the hepatic cirrhosis. The key factors influencing the survival of the patients include postoperative infection, acute and chronic rejection, pulmonary complications and bile duct complications. Piggyback OLT has little effect on the haemodynamics of whole body.