心脏死亡供者供肝肝移植11例疗效观察

The clinical evaluation of Maastricht type 3 donation after cardiac death liver transplantation in 11 cases

目的观察利用Maastricht分类第Ⅲ型心脏死亡供者（donorsaftercardiacdeath，DCD）供肝行原位肝移植的疗效。方法2011年9月至2012年6月期间，吉林大学白求恩第一医院共有14例DCD供者进行器官捐献，其中11例行原位肝移植，分析总结心脏死亡供肝行肝移植的疗效。结果本组11例DCD供肝热缺血时间为（21．3±2．6）min，冷缺血时间为（2．5±0．8）h，供肝质量为（1245±180）g。11例受体行原位肝移植术，术中无肝期42～80min，手术时间380—740min，术中出血量600—3000ml，平均1750ml。除1例受体于术后第3天死于原发移植肝无功能外，其余受体术后均恢复良好。在全程随访期间预后较好，均未出现排斥反应及胆管、血管并发症。结论通过规范捐献流程、尽量减少冷、热缺血时间及加强器官功能维护，利用Maastricht分类第Ⅲ型心脏死亡供者供肝对终末期肝脏疾病患者行肝移植，疗效良好。

Objective To evaluate the effect of liver transplantation using Maastricht Ⅲ DCD donor liver on clinical results. Method From September 2011 to June 2012, we had 14 cases of controlled cardiac death donors, of which 11 donor grafts were used for in situ liver transplantation, we evaluate these 11 in sitn liver transplantations cases by data analysis. Results The warm iscbemia time was （21.3 ±2. 6） min, and cold ischemia time was （2. 5 ±0. 8） h, the mass of donor liver was （ 1245 ±180） g. The anhepatic phase was 42 - 80 min, the length of operation was 380 - 740 min. Blood loss was 600 - 3000 ml, averaging 1750 ml. One recipient died of primary liver graft non-function on the 3rd day after surgery, 10 patients recovered well. The prognosis was good in the entire follow-up period, and there were no bile duct and vascular complications. Conclusions The result of end-stage liver disease patients receiving Maastricht ⅢDCD donor liver graft in situ liver transplantation is satisfactory.