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成人—成人间活体右半肝移植 被引量:1

ADULTTOADULT LIVING DONOR LIVER TRANSPLANTATION USING RIGHT LOBE GRAFTS
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摘要 目的报道对高度紧急的成人终末期肝病患者进行活体右半肝移植的经验。病人及方法自1996年5月到1998年8月,对15例高度紧急的成人终末期肝病患者进行了活体右半肝移植。13例术前在重症监护病房,2例因肝病的并发症而住院。供体和受体的平均体重分别为58kg(41~84kg)和66kg(45~100kg),9例受体体重大于供体,最低的供体同受体体重比例为0.62∶1。如果估计左肝叶的体重小于受体预计标准肝重量的40%,则选择右半肝。结果供体手术的平均失血量为800ml(300~1600ml),供体的平均住院时间为13天(6~38天)。14例供体未输血。2例供体术后发生并发症,1例是切口疝,另1例是胆道狭窄,他们在出院后需要接受第二次手术。移植肝的平均重量为719克(490~1140g),所有移植肝均立即恢复功能,病人精神状态康复,凝血酶原时间恢复正常。11例受体需要再次手术探查。2例(13.3%)患者死亡,1例在术后16天死于全身性念珠菌感染。另1例在术后22天死于门静脉栓塞。13例(86.7%)受体存活,生活质量良好。结论认为由一支具有丰富肝切除及肝移植经验的医生队伍来行右半肝的活体肝移植能达到较好的结果,采用? Objective To report our experience in living donor liver transplantation(LDLT) using right lobe grafts for adult patients under highurgency situations Patients and Methods From May 1996 to August 1998,15 LDLTs using right lobe grafts were performed under highurgency situations.Thirteen recipients were in intensive care units and two recipients were in hospital with complications of liver disease.The median weight for the donors and recipients was 58 kg(range,4184kg)and 66 kg(range,45100kg),respectively.The body weight of nine donors was less than that of the corresponding recipients,and the lowest donortorecipient body weight ratio was .0611.The right lobe graft was chosen bacause the left lobe volume was less than 40% of the ideal liver mass of the recipients. Results The median blood loss of donors was 800ml(range,3001600ml)and hospital stay was 13 days (range,638days).Homologous blood transfusion was not required in 14 domors.Two donors had complications(one incisional hernia and one bile duct str
出处 《肝胆外科杂志》 1999年第3期174-177,共4页 Journal of Hepatobiliary Surgery
关键词 肝移植 肝切除 成人 活体肝 Living donor liver transplantationHepatectomyicture)requiring reoperation after discharge.The median graft weight was 719 g (range,4901140 g).All grafts showed immediate function with normalization of prothrombin time and all recipients regained to consci
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