无肝期、冷缺血期、热缺血期对小儿活体肝移植术中肝功能影响的研究

Research on the effect of anhepatic phase,cold ischemia and warm ischemia on the liver function during living donor liver transplantation in children

目的探讨小儿活体肝移植术中无肝期、冷缺血期、热缺血期对术中肝功能影响,为指导临床手术提供帮助。方法 2006年6月至2009年3月共收治23例肝移植患儿,分别记录术中无肝期、冷缺血期、热缺血期时间及术中肝功能,分析肝功能变化与术中无肝期、冷缺血期、热缺血期长短是否相关。结果术中无肝期长短与无肝期后总胆红素(TB)上升明显相关(r=0.82,P<0.000 1)。除此之外,术中无肝期、冷缺血期、热缺血期长短与术中肝功能变化无关。结论小儿活体肝移植无肝期长导致未结合胆红素无法经肝代谢为结合胆红素而排出体外,可引起总胆红素上升。因活体肝移植较全肝原位肝移植冷、热缺血时间均短,因此,对术中肝功能影响较小。

Objective To investigate the effect of anhepatic phase,cold ischemia and warm ischemia on the liver function during living donor liver transplantation（LDLT） in children.Methods 23 cases of LDLT were done in our hospital from June 2006 to March 2009.The duration of anhepatic phase,cold ischemia,warm ischemia and liver function during operation were recorded,and the relationship between them were analysed with SPSS15.0.Results Elevation of total bilirubin（TB） was correlated to the duration of anhepatic phase.Besides that there were no relationship between anhepatic phase,cold ischemia,warm ischemia and liver function.Conclusion Prolonged anhepatic phase may cause metabolic disorder and elevate of unconjugated bilirubin and TB.Duration of anhepatic phase,cold ischemia,warm ischemia is always short in LDLT in children,and thus has little effect on liver function in operation.