1例高钠血症老年供者供肝移植成功的病例报告及经验总结

A case report and experience summary of successful donor liver transplantation from an elderly donor with hypernatremia

目的总结高钠血症老年供者的供肝捐献评估事项,并分析移植受者预后,为高钠血症老年供者的获取前维护及受者的移植术后恢复提供参考。方法回顾性分析1例合并高钠血症的脑干出血致脑死亡老年供者供肝移植的临床资料。结合文献复习,对该类供者的供肝捐献评估及受者术后管理事项进行总结。结果供者为老年(74岁)男性,合并高钠血症,存在心肺复苏史,属于脑死亡器官捐献;受者为41岁男性,因乙型肝炎后肝硬化失代偿期行肝移植术。术后给予受者抗排斥、抗感染等治疗,其肝功能逐渐恢复正常,术后24 d顺利出院,随访至今预后较好。结论经过对供受者术前全面评估后,高钠血症老年供肝可安全应用于肝移植,对肝移植受者早期肝功能恢复及预后无显著影响。

Objective To summarize items of donation evaluation of donor liver from an elderly donor with hypernatremia,and to analyze recipient's prognosis,so as to provide reference for pre-acquisition maintenance of elderly donor with hypernatremia and post-transplantation recovery of recipient.Methods The clinical data of liver transplantation from one elderly donor with hypernatremia,whose brain death was resulted by brain stem hemorrhage,were retrospectively analyzed.Combined with literature reviews,summary on donor liver donation evaluation of this category of donors and on recipients'postoperative management items was performed.Results The donor was an elderly male(74 years old)and concomitant hypernatremia,had history of cardiopulmonary resuscitation,and belonged to brain dead organ donation.The recipient was a 41-year-old male who underwent liver transplantation due to decompensation of liver cirrhosis after hepatitis B.After anti-rejection and anti-infection treatment of operation,liver function of the recipient gradually returned to normal,and the recipient was discharged 24 days after operation;in addition,follow-up so far the prognosis is favorable.Conclusion After a thorough preoperative evaluation of the donor and recipient,hypernatremia elderly donor liver can be safely used in liver transplantation,and has no significant effect on early liver function recovery and prognosis of liver transplant recipient.