肝移植术后早期动脉并发症的治疗与预后

Diagnosis and treatment of early-stage hepatic artery complications after orthotopic liver transplantation

目的探讨原位肝移植术（OLT）后动脉并发症的危险因素和诊治策略。方法回顾性分析2005年1月至2007年9月180例原位肝移植临床资料。比较肝良性疾病与原发性肝癌原位肝移植术后动脉并发症的发生率。观察动脉并发症受者的长期生存率。结果180例中，12例（6．7％）发生动脉并发症，其中肝动脉血栓（HAT）3例，肝动脉狭窄（HAS）9例。原发性肝癌肝移植术后动脉并发症发生率（6／39）显著高于良性肝病（6／141）（P〈0．05）。结论及时诊断并根据肝移植术后动脉并发症的类型选择恰当的方法是治疗原位肝移植术后动脉并发症的关键。

Objective To determine the risk factors and the optimal management of hepatic artery complications （HAC） after orthotopic liver transplantation. Methods The clinical data of 180 orthotopic liver transplantation patients performed between January 2005 and September 2007 was reviewed. The incidence of HAC between primary liver carcinoma and benign diseases of liver was compared. Results Twelve （6.7%） episodes of HAC were identified. 3 were hepatic artery thrombosis （HAT） and 9 were hepatic artery stenosis （HAS）. The incidence of HAC in patients with primary liver carcinoma （6/39） was higher than benign disease （6/141）（P〈0.05）. Conclusions The keys to management of HAC after orthotopic liver transplantation are to diagnose the complication in time and to select the proper treatment based on the type of HAC.