Dou K, Guan W, Li K, Gao Z, Fu Y, Zhang X, Cao Y, Zhao Q, Shi X, Yue S, Tao K, An J, Wang D, Dai H
Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032.
Zhonghua Wai Ke Za Zhi. 1998 Apr;36(4):203-5.
To study a case of living related liver transplantation.
The patient was a 10-year-old girl who suffered from congenital diffuse intrahepatic cholangiectasis, recurrent cholangitis and hepatocirrhosis. The donor was the patient's father aged 40. The left lateral lobe of donor's liver was cut and grafted to the patient. Intensive care and treatment as well as follow-up were given after operation.
For the donor, the operation lasted 400 min, with 410 ml bleeding and 300 g liver removed. The recovery was satisfactory. For the recipient, the operation lasted 652 min, with 1665 ml bleeding, 80 min non-liver stage, 0 min graft hot ischemic stage, and 137 min cold ischemic stage. Immunosuppressive therapy was given using cyclosporin A, azathioprine and adrenocortical hormones. There was an acute rejection 11 days after operation, which was controlled using hormone impulsive therapy. The patient has been surviving 7 months with normal liver function.
The living related liver transplantation is feasible under modern surgical conditions. It is demonstrated that perfect postoperative management is the key for the successful liver transplantation.
研究一例亲属活体肝移植病例。
患者为一名10岁女童,患有先天性弥漫性肝内胆管扩张症、复发性胆管炎和肝硬化。供体为患者40岁的父亲。切取供体肝脏左外叶并移植给患者。术后给予重症监护、治疗及随访。
供体手术历时400分钟,出血410毫升,切除肝脏300克,恢复情况良好。受体手术历时652分钟,出血1665毫升,无肝期80分钟,移植肝热缺血期0分钟,冷缺血期137分钟。采用环孢素A、硫唑嘌呤和肾上腺皮质激素进行免疫抑制治疗。术后11天发生急性排斥反应,通过激素冲击治疗得以控制。患者已存活7个月,肝功能正常。
在现代外科条件下,亲属活体肝移植是可行的。表明完善的术后管理是肝移植成功的关键。