小儿临床活体肝部分移植术

Reduced Size Living Related Liver Transplantation in Child: Case Report

目的 探讨小儿临床活体肝部分移植术的技术。方法 １９９７ 年６ 月３０ 日我科成功地进行了１ 例小儿临床活体肝部分移植术。供体男性，４０ 岁， 系患儿父亲， 行肝左外侧叶切除术（ 脏脏Ⅰ、Ⅱ段） 。术中用Ｂ超确认肝血管走向， 确定切肝界线， 以超声刀和双极电凝器断肝， 切肝过程不阻断肝脏血流， 肝脏热缺血时间为零。受体为１０ 岁女童，体重２４ｋｇ， 身高１２１ｃｍ ，为先天性弥漫性肝内胆管囊性扩张症、复发性胆管炎、肝硬变。结果 供体无任何术后并发症， 受体早期并发症得以控制， 至今已健康存活１１ 月余。结论 成功的活体肝脏切除技术是肝移植提供优质供肝的重要保障， 本例的成功为小儿肝移植提供了新的前景。

Objective To review the technicality of living related, reduced size pediatric liver transplant. Methods The authors successfully performed a living related liver transplantation in June. 1997. The recipient was a 10 year old girl (weight 24?kg, height 121?cm) with Caroli's disease and recurrent cholangitis. The donor was her father who aged 40 years. The left lateral segment (segments Ⅰand Ⅱ) was used for the graft. Transection was mapped by intra operative ultrasound. The parenchymal resection was carried out with an ultrasound dissector and double electro coagulator without vascular occlusion. The warm ischaemic time was zero. Results The donor had no operative complication. The early complications of the recipient were effectively managed. Conclusions Successful donor hepatectomy is crucial in living related liver transplant. The initial success is promising for the future of pediatric liver transplantation in China.