成人-成人活体右半肝移植16例报告

Adult-to-adult living related right lobe liver transplantation

目的 报道东京大学 16例成人终末期肝病患者进行活体右半肝移植的经验。方法 统计自 2 0 0 0年 10月到 2 0 0 1年 4月 ,对 16例成人终末期肝病患者进行了活体右半肝移植。供体和受体的平均体重分别为 5 5kg(42 - 78kg)和 5 7kg(41- 81kg)。结果 供体手术的平均失血量为 80 0ml(30 0 - 16 0 0ml) ,供体的平均住院时间为 12d(6 - 38d)。 14例供体未输血。 1例供体术后发生并发症。移植肝的平均重量为 719g(45 0 - 10 5 0g) ,所有移植肝均立即恢复功能 ,病人精神状态康复 ,凝血酶原时间恢复正常。 2例受体需要再次手术探查。 2例患者死亡 (1例在术后 16d死于全身性念珠菌感染 ,另 1例在术后 2 6d死于门静脉栓塞 )。结论 认为采用右半肝的活体肝移植可以提供足够体积和功能的肝脏达到较好的结果 。

Objective To report the clinical application of 16 case living related right liver transplantation in Tokyo University. Methods A retrospective analysis was made of 16 cases of living related liver transplantation from October, 2000 to April, 2001. The average weight of donors was 55 kg (42-78 kg), the recipients 57 kg (41-81 kg).Results 16 cases of operations were all successful. For the donor, the average blood loss of the operation was 800 ml (300-1 600 ml), the mean postoperative stay were 12 (6-38) days. 14 cases of the donors didn't need blood transfusion. 1 donor developed postoperative complication. The average weight of the liver was 719 g (450- 1 050 g). All of the grafts recovered their function soon. 2 cases of recipients received the second operation. 2 patients died after the operation, one died of severe infection, the other died of embolism of portal vein. Conclusions The results of the living related right liver transplantation in adult are satisfactory.