Reding R, Chardot C, Paul K, Veyckemans F, Van Obbergh L, De Clety S C, Detaille T, Clapuyt P, Saint-Martin C, Janssen M, Lerut J, Sokal E, Otte J B
Pediatric Liver Transplant Program, Department of Surgery, Saint-Luc University Clinics, Université catholique de Louvain, Brussels, Belgium.
Acta Chir Belg. 2001 Jan-Feb;101(1):17-9.
The Brussels series of living related liver transplantation (LRLT) in 77 children (< 15 years) is reviewed. Median (range) recipient age at liver transplantation was 1.1 year (0.4-13.1). The main indication for LT was biliary atresia in 55/77 cases (71%). The living-related donor was one of the parents in 74 instances. Hepatic segments 2-3 (n = 67) or 2-3-4 (n = 10) were implanted orthotopically, with a median (range) graft weight to recipient body weight ratio of 3.17% (0.91-8.08). No severe complications or significant long-term sequelae were encountered in the living donors. One and five year survival rates were 92% and 89% for the patients, and 90% and 86% for the grafts, respectively. The retransplantation rate was 2/77 (2.6%), the indication being chronic rejection in both instances. In conclusion, LRLT is now a validated procedure in the living donors as well as in pediatric recipients with chronic or acute liver diseases. In the current context of organ shortage, it provides a valuable alternative to cadaveric LT.
本文回顾了布鲁塞尔针对77名15岁以下儿童开展的活体亲属肝移植(LRLT)系列手术。肝移植时受者的年龄中位数(范围)为1.1岁(0.4 - 13.1岁)。肝移植的主要适应证是55/77例(71%)的胆道闭锁。74例中活体亲属供者为父母一方。将肝段2 - 3(n = 67)或2 - 3 - 4(n = 10)原位植入,移植肝重量与受者体重之比的中位数(范围)为3.17%(0.91 - 8.08)。活体供者未出现严重并发症或明显的长期后遗症。患者的1年和5年生存率分别为92%和89%,移植肝的1年和5年生存率分别为90%和86%。再次移植率为2/77(2.6%),两次均因慢性排斥反应。总之,活体亲属肝移植目前在活体供者以及患有慢性或急性肝病的儿童受者中是一种经过验证的手术方式。在当前器官短缺的情况下,它为尸体肝移植提供了一种有价值的替代方案。