Sugawara Yasuhiko, Makuuchi Masatoshi, Takayama Tadatoshi, Imamura Hiroshi, Kaneko Junichi, Ohkubo Takao
Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo, Japan.
Liver Transpl. 2002 Jan;8(1):58-62. doi: 10.1053/jlts.2002.29761.
Minimizing the risk of donor hepatectomy while preserving graft viability is an important concern in living related liver transplantation. This report describes clinical outcomes for living donor hepatectomy with reference to the type of hepatectomy. Donor hepatectomy was performed in 130 consecutive living donors. They were divided into three groups: left lateral or extended left lateral segmentectomy (group S; n = 50), left hepatectomy with or without caudate lobe or right lateral resection (group L; n = 64), and right hepatectomy (group R; n = 16). Intraoperative and postoperative data were examined and compared among the groups. No critical complications were observed in any group. However, there were differences in donor age, surgical and ischemia times, volume of blood loss, graft weight, and aspartate aminotransferase level elevation among the groups. Livers showed a substantial increase in volume, tending to the standard liver volume 1 month after surgery. Regardless of the extent of donor hepatectomy, serious complications did not occur after surgery. Surgical risk for a living donor is minimal if the operation is performed by experienced surgeons using present procedures.
在活体亲属肝移植中，在确保移植物存活的同时尽量降低供体肝切除的风险是一个重要问题。本报告参照肝切除类型描述了活体供体肝切除的临床结果。对130例连续活体供体进行了肝切除。他们被分为三组：左外侧或扩大左外侧段切除术（S组；n = 50）、含或不含尾状叶的左肝切除术或右外侧切除术（L组；n = 64）以及右肝切除术（R组；n = 16）。对各组的术中及术后数据进行了检查和比较。任何一组均未观察到严重并发症。然而，各组之间在供体年龄、手术时间和缺血时间、失血量、移植物重量以及天冬氨酸转氨酶水平升高方面存在差异。术后1个月肝脏体积显著增加，趋于标准肝脏体积。无论供体肝切除范围如何，术后均未发生严重并发症。如果由经验丰富的外科医生采用当前手术方法进行手术，活体供体的手术风险极小。
