预防成人DCD肝移植术后大肝综合征的外科新策略

A new surgical strategy for preventing large-for-size syndrome after DCD liver transplantation in adults

大肝综合征(large-for-size syndrome,LFSS)是因移植物与受体腹腔大小不匹配,腹腔及胸腔脏器受压而出现的一种致死性并发症。近年来,随着肥胖供体在供体池中比例的增加,各移植中心面临LFSS的概率也逐年上升。然而,目前对于如何有效预防成人公民逝世后器官捐献供体(death after citizen death,DCD)肝移植术后LFSS仍不清楚,各移植中心几乎都凭借经验处之,尚无一个客观的防治策略。本文总结了目前预防成人DCD肝移植术后LFSS中存在的问题,以及团队针对存在问题进行的探索。

Large-for-size syndrome(LFSS)is a fatal complication of abdominal and thoracic organ compression due to mismatch of the size of the graft and recipient abdominal cavity.In recent years,with the increased prevalence of obesity epidemic among the donor pool,the incidence of LFSS tends to increase in adult liver transplantation.However,it is still unclear how to effectively prevent LFSS after adult death after citizen death(DCD)liver transplantation.Almost all transplantation centers rely on experience to deal with it,and there is no objective prevention strategy.This article summarizes the current problems in preventing LFSS after adult DCD liver transplantation,and our team’s exploration of the existing problems.