中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (02): 162-164.

• 论著 • 上一篇    下一篇

成人右半肝活体肝移植21例分析

林栋栋，卢实春，李    宁，王孟龙，张    毅，伏    志，郭庆良，赖    威，朱    岳   

  1. 首都医科大学附属北京佑安医院肝胆外科暨肝脏移植中心，北京100069
  • 出版日期:2011-02-01 发布日期:2011-05-30

  • Online:2011-02-01 Published:2011-05-30

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摘要：

目的    探讨成人右半肝活体肝移植供受者处理的关键性技术问题。方法    回顾性分析2007年4月至2009年5月首都医科大学附属北京佑安医院肝胆外科完成21例成人右半肝活体肝移植的资料。 结果    供者术后无死亡，发生并发症23例次，按照Clavien系统分级：Ⅰ级15例次，Ⅱ级8例次。经积极非手术治疗后，所有供者均痊愈。受者术后发生胆道并发症7例，均经外科手术处理痊愈，术后1个月内死亡4例。移植物含肝中静脉4例，不含肝中静脉17例，两组受者1年存活率分别为75%与76%（χ2 = 1.000，P = 0.617）。 结论    右半肝活体肝移植是治疗终末期肝病尤其是各种原因导致的急性肝功能衰竭的重要手段。仔细术前评估，精细手术操作，合理地分配肝中静脉并保证移植物和残肝的功能性体积，术后密切监护、妥善处理并发症是供受者安全的重要保证。

关键词: 肝移植；活体供者；右半肝 

Abstract:

Adult-adult right lobe graft living donor liver transplantation: an analysis of 21 cases        LIN Dong-dong, LU Shi-chun, LI Ning, et al. Liver Transplantation Center, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China
Corresponding author：LI Ning, E-mail：liningbjyah@vip.sina.com
Abstract    Objective    To investigate the key technical skills in adult-adult right lobe graft living donor liver transplantation.  Methods    The clinical data of 21 adult donors and recipients who underwent right lobe living donor liver transplantation from April 2007 to May 2009 at Beijing You’an Hospital Affiliated to Capital Medical University were analyzed retrospectively. Results    There was no death in donors. Twenty-three complications were cured smoothly. Fifteen complications belonged to Grade I and the other 8 complications belonged to Grade II by Clavien classification. There were 4 recipients death in one month after operation and 7 biliary complications occurred during following-up period. All biliary complications were cured by surgical procedures. Four right lobe grafts included middle hepatic vein (group A), 17 right lobe grafts didn’t include middle hepatic vein (group B). There was no significant difference (χ2 =1.000, P=0.617) in 1 year survival rate between group A (75%) and group B (76%).  Conclusion    Adult-adult right lobe living donor liver transplantation is an important modality for end-stage liver disease patients, especially for patients with liver failure. Rigorous preoperative evaluation, careful operation, proper distribution of middle hepatic vein to maintain graft and remnant liver functional volume, and intensive postoperative care are guarantee for the safety of donors and recipients in living donor liver transplantation.

Key words:  , liver transplantation；living donor；right lobe graft