活体部分小肠移植供受体围手术期的处理

The perioperative management of living related small bowel transplantation

目的 报告国内首例活体部分小肠移植的手术经过和围手术期处理。方法 受者为男性 ,18岁 ,因短肠综合征而接受小肠移植。供体 ,男性 ,44岁 ,为受体之父。取供体回肠末段 15 0cm ,移植肠血管与肾下腹主动脉、下腔静脉吻合 ,移植肠近端与受体残留空肠近端行端端吻合 ,移植肠远端与受体残留空肠远端行侧端吻合 ,移植肠末端造口作为观察窗。免疫抑制方案为FK 5 0 6、骁悉、甲基强的松龙联合用药。结果 受者术后已健康生存 340d ,移植肠功能恢复良好。结论 活体小肠移植是治疗短肠综合征较理想的方法 。

Objective To summarize the experience of perioperative management in living related small bowel transplantation.[WT5”HZ] Methods[WT5”BZ] An 18 year old boy with short gut syndrome underwent the living related small bowel transplantation, with the graft taken from his father (44 year old). A segment of 150?cm distal small bowel was resected from the donor and the graft was irrigated with UW solution. The donor's ilecolic artery and vein were anastomosed to the recipient's infrarenal aorta and vena cava respectively.The intestinal continuity was restored with an end to end anastomosis between the recipient's jejunum and the donor's ileum., and the distal end was fistulized. Posttransplant immunosuppression was initially administered with FK506, MMF, and prednisone.[WT5”HZ] Result[WT5”BZ] Up to the time this report was submitted the recipient has enjoyed good life quality for 340 days, the graft small bowel remains functional.[WT5”HZ]Conclusion[WT5”BZ] The living related small bowel transplantation cures the short gut syndrome in this case, the perioperative management was the key of successful transplantation.