异位辅助性肝移植门静脉动脉化的研究进展

Updates of heterotopic auxiliary liver transplantation with portal vein arterialization

近年来，肝移植供肝短缺这一世界难题越来越受到国内外移植学者的关注。鉴于此，异位辅助性肝移植应运而生，其概念是指在保留部分或整个原肝的情况下，将供肝的全部或部分植入受者原肝位置以外的移植方法。而对于门静脉条件差需要肝移植的患者，供肝门静脉如何重建成为一大难点。因此，有学者提出门静脉动脉化（PVA），即通过建立动脉和门静脉或其分支之间的通路，以增加动脉血或代替门静脉血灌注肝脏的方法。笔者就异位辅助性肝移植PVA的研究背景与现状，供肝植入位置，血管重建及重建后的血流动力学机制与肝脏再生进行深入探讨。

In recent years, liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars. In view of that, heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the origi- nal liver were retained. As for the liver transplantation with poor conditions on portal vein, reconstruction of portal vein has beeome an aporia. Based on this, some scholars put forward the theory--arterialization of portal vein（PVA） , namely a method to increase arterial blood supply or replace portal vein blood perfu- sion of liver by establishing some pathes among artery and portal vein or its branches. The research background and current situa- tion of heterotopic auxiliary liver transplantation with portal vein arterialization, the transplanting position of donor liver, vessel reconstruction, dynamics mechanism after reconstruction and liv- er regene-ration are summarized in this review.