胸腹部多器官联合切取技术方法探讨

The technique of combined thoracic and abdominal multiple organ procurement

目的探讨胸腹部多器官联合切取的技术方法及其对获取的器官质量的影响。方法采取胸部U型切口联合腹部大"十"切口,分别建立胸部器官和腹部器官原位灌注,在灌注的同时进行多器官游离和切取。结果 2003年至今采用此方法行胸、腹腔多器官联合切取术8次,获得供心、肝、胰各8个,供肺8对及供肾16个。热缺血时间为(2±1.2)min,器官切取时间约(20±3)min。未出现任何影响器官质量和功能的手术意外损伤。临床行心脏移植6例、心肺联合移植2例、双肺移植3例、单肺移植5例、肝移植6例、肝肾联合移植2例、胰肾联合移植3例、肾移植11例,所有移植器官均在术后立即发挥功能。结论采用胸腹部多器官联合切取的技术方法能够快速优质的获取胸部和腹部供器官,缩短热缺血时间,减少手术损伤,提高供器官的质量和数量。

Objective To explore the clinical efficiency of the combined thoracic and abdominal multiple organ procurement. Methods We used U type thoracic incision combined with big cross abdominal incision, to set up in situ perfusion of thoracic and abdominal organs, while during the procedure of organs perfusion, we separated and en bloc harvested thoracic and abdominal organs. Results From 2003 to now, 8 cases underwent this surgical treatment, with the harvesting of 8 donor hearts, livers, pancreases, 8 pairs of lungs and 16 kidneys respectively. Warm ischemic time was about 2.0＋1.2 rain. No donor organs and vessels were damaged. Heart transplantation was performed in 6 cases, heart-ltmg combined transplantation in 2, double lung transplantation in 3, single lung transplantation in 5, liver-kidney combined transplantation in 2, pancreas-kidney combined transplantation in 3 and kidney transplantation in 11, respectively. The functions of all transplanted allograft recovered well. Conclusions Using combined thoracic and abdominal multiple organ procurement, the surgical process is rapidly and safely, which short the warm ischemic time and improve the activity and functions of donor organs.