劈离式肝移植10例临床分析

A clinical report of 10 cases of split liver transplantation

目的评价劈离式肝移植（SLT）的临床效果，并探讨其可行性。方法回顾性分析2006年6月至2007年1月间10例SLT的临床资料，观察受者术后肝功能恢复状况，受者及移植肝存活率以及血管并发症、胆管并发症的发生率。结果10例受者术后中位随访时间16个月（1～23个月），受者及移植肝1年存活率均为70％（7／10）。肝动脉血栓形成1例（10％），胆管并发症4例（40％）。结论尽管SLT仍存在较高的技术并发症发生率，但受者及移植物存活率与全肝移植相近。为解决供者短缺的严重问题，可在临床上选择性应用SLT。

Objective To investigate clinical effectiveness of split liver transplantation （SLT）. Methods A retrospective analysis was conducted on 10 split liver transplantations that performed at the First Central Hospital of Tianjin between June. 2006 and Jan. 2007. The survival rate of patient and graft, recovery of liver function, and incidence of vascular complications and biliary complications were observed. Results The median follow-up duration of all these 10 patients was 16 months （1-23 months）. One-year patient and graft survival rate was 70 %. One case （10 %） had vascular complications, and 4 cases （40 %） biliary complications. Conclusions The survival rate of patient and graft after SLT was comparable to that after whole liver transplantation, but surgical complications especially biliary complication occur more commonly. SLT can be selectively applied to expand the current donor pool.