同种原位背驮式减体肝移植技术

OPTHOTOPIC LIVER TRANSPLANTATION USED BY PIGGYBACK OF REDUCEDSIZE HTCHNIQUE

继中国首例背驮式同种原位肝移植（ＰＢＯＬＴ－Ｐｉｇｇｙｂａｃｋｏｒｔｈｏｔｏｐｉｃｌｉｖｅｒｔｒａｎｓｐｌａｎｔａｔｉｏｎ）在同济医院施行成功近１年后，作者又于１９９６年采用背驮式减体积同种原位肝移植（ＰＢＲＳＯＬＴ－Ｐｉｇｇｙｂａｃｋｒｅｄｕｃｅｄ－ｓｉｚｅｏｒｔｈｏｔｏｐｉｃｌｉｖｅｒｔｒａｎｓｐｌａｎｔａｔｉｏｎ）技术为１例９岁，体重仅２０．５ｋｇ的男性Ｗｉｌｓｏｎ氏患儿成攻施行了手术，该手术与经典的同种原位肝移植（ＳＯＬＴ）相比下半躯体静脉回流影响小，内环境干扰小，有利于患者术后恢复，此例ＰＢＲＳＯＬＴ施行成功，填补了中国儿童肝移植手术技术的空白，为儿童各种良性终末期肝脏疾病开创了新的外科治疗手段，兹就手术技术、术式优点进行讨论。

It is nearly one year since the PBOLT(Piggy back orthotopic liver transplantation)was first performed in Tongji hospital.Now,PBOLT(Piggy back reducedsize orthotopic liver transplantation)has been adopted.The patient was 9 years and his body weight was 20.5kg.Compared to the SOLT(standard orthotopic liver transplantation),PBRSOLT do not need venvenous bypass(VVB)throughout anhepatic phase and it is a transplantation with the preservation of inferior vena cave(IVC)and hepatic veins with resecting the invalid liver.Therefore,The stabilization of hemodynamics and internal environment is the advantage of this technique.As the donor liveis too large,its size must be reduced to implant it into the patient who looks like a sixyear child.This PBRSOLT filled up the space of the technique of the liver transplantation for children.It is a new surgical method for children's begin endstage hepatopathy.The operation technique and its advantage are discussed in this article.