33例小儿活体肝移植术肝动脉并发症分析

LIVING-RELATED DONOR LIVER TRANSPLANTANTION:A REPORT OF 32 CASES

目的研究小儿活体肝移植手术后肝动脉并发症,分析肝动脉血栓形成(HAT)相关原因及其诊治经验。方法回顾分析上海交通大学医学院附属仁济医院器官移植科自2006年10月至2009年9月所行33例小儿活体肝移植手术相关资料。结果 33例移植患儿均接受亲属左外叶供肝,随访1年。共出现肝动脉栓塞3例(9.1%),2例经DSA溶栓后痊愈。结论小儿活体肝移植术术后发生肝动脉血栓几率较高,使用显微外科技术吻合肝动脉可以降低肝动脉血栓发生率,对可疑患者行肝动脉造影可有效诊断和治疗肝动脉血栓。

Objective To analyse the hepatic arter complication of paediatric liver transplantation（LT）,and to summarize the experience in reduce hepatic artery thrombosis（HAT） of Paediatric LT.Methods The clinical data of 33 patients of all children who underwent LT from Oct,2006 to Sep,2009 were reviewed retrospectively.Results Thirty-three children have undergone 33 LTs were analysed with a minimum follow up of 12 months.We observed HAT in 3 of 33（9.1%） transplants in our pediatric liver transplant population.Two of the 3 cases diagnosed as postoperative HAT by hepatic artery angiography were cured by thrombolysis.Conclusions Children have been reported to be at greater risk for hepatic artery thrombosis when compared to adults.The microsurgical reconstruction of hepatic artery can significantly decrease the incidence of postoperative HAT in paediatric liver transplantation.Postoperative HAT can be diagnosed accurately by hepatic artery angiography,and thrombolysis is efective treatment for HAT management.