人工血管应用于活体肝移植流出道重建的价值

V alue of artificial blood vessel in outflow reconstruction during living donor liver transplantation

目的探讨活体肝移植中应用人造血管进行静脉流出道重建的安全性及有效性。方法2018年9月至2020年4月期间,14例活体肝移植受者使用人工血管进行流出道重建,共重建25支血管,回顾分析术后重建血管通畅率及闭塞血管引流段交通支形成率,受者肝功能及并发症发生情况。结果术后1周、1个月、3个月及6个月重建血管通畅率及闭塞血管引流段交通支形成率分别为88%.84%、63.6%、59%及0%.50%.62.5%、66.7%,术后2周肝功能基本恢复正常,无血管重建区域感染、血肿及间置血管出血等并发症发生。结论人工血管重建移植肝流出道,增加了肝静脉回流,利于移植肝功能恢复,重建血管相关并发症并未增加。

Objective To explore the safety and efectiveness of reconstructing venous outlow tract with artificial blood vessels during living donor liver transplantation.Methods From September 2018 to April 2020,14 cases of living related liver transplantation underwent outflow tract reconstruction with artificial blood vessels.A total of 25 blood vessels were reconstructed.The patency rate of reconstructed blood vessels,the formation rate of collateral circulation,the status of liver function and the occurrence of complications were analyzed retrospectively.Results At1 week,1 month,3 months and 6 months post-operation,the patency rate of reconstructed blood vessels and the formation rate of collateral circulation were 88%,84%,63.6%,59%and0%,50%,62.5%,66.7%respectively.At 2 weeks post-operation,liver function normalized basically and there were no such complications as infection,hematoma or interposition hemorrhage.Conclusions Reconstructing outlow tract of transplanted liver by artificial vessel increases the reflux of hepatic vein and benefits the recovery of liver function.And the complications related to vascular reconstruction are not heightened,