临床活体部分小肠移植术的血管处理技术

The management of graft blood vessel in the living-related small bowel transplantation

目的 报告我国首例活体小肠移植术的血管处理技术。方法 为 1例 18岁的男性超短肠综合症患者施行了活体部分小肠移植术 ,供肠来自患者的父亲 ,切取供体回肠 15 0cm ,UW液灌洗血管。将移植肠动、静脉分别与受体腹主动脉及下腔静脉端侧吻合。移植肠近端与受体空肠近端行端端吻合 ,移植肠远端与受体空肠远端行侧端吻合 ,末端造口。术后给予抗排斥 ,抗感染 ,抗凝及营养支持等治疗。结果 术后曾出现贫血 ,单纯疱疹感染和急性排斥反应 ,经积极处理得到控制 ,目前患者健康 ,生存 11月余。结论 活体小肠移植术中处理好供、受体的血管对手术成功至关重要。

Objective[WT5”BZ] To sum up the experience in the management of graft blood vessel of living-related small bowel transplantation. [WT5”HZ]Methods[WT5”BZ] An 18-year-old boy with short gut syndrome underwent living-related small bowel transplantation, the graft was from his father (44-year-old). A segment of 150*!cm distal small bowel was resected from the donor and the graft's vasculature was infused with UW solution. The donor's ilecolic artery and vein were anastomosed to the recipient's infrarenal aorta and IVC 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 made as the fistulization. Treatment of immunosuppression, antibiotics, antithrombosis and nutrition support was given posttransplantation.[WT5”HZ] Results[WT5”BZ] After operation, the complications such as herpes simplex virus infection, intestinal hemorrhage and acute rejection occurred in the recipient, but they were all handled properly and brought under control. The transplantation was performed 11 months ago and the patient enjoys good health.[WT5”HZ]Conclusions[WT5”BZ] It is very important for a successful operation to handle the vasculature and graft of the recipient properly during the operation. [WT5”HZ]