Steinmüller T, Pascher A, Sauer I M, Theruvath T, Müller A R, Settmacher U, Neuhaus P
Klinik für Allgemein, Viszeral und Transplantationschirurgie, Charité, Campus Virchow, Medizinische Fakultät der Humboldt Universität zu Berlin, Germany.
Dtsch Med Wochenschr. 2002 May 17;127(20):1067-71. doi: 10.1055/s-2002-30123.
Adult living donor liver transplantation has been established in an increasing number of transplant centres during the last few years. Donor safety and risks are important criteria influencing the further development. We report our experience with 43 adult-to-adult right lobe living donor liver transplantations.
43 patients (mean age: 49,8 +/- 16,0 years; f:m = 14:29) with end-stage liver disease received a right lobe liver graft from an adult living donor (mean age: 42,4 +/- 13,4 years; f:m = 27:16) between December 1999 and December 2001. An approval by the local ethics committee was obtained prior to the start of the programme and each donation.
None of the donors experienced fatal or long-term complications. The rate of surgical complications in donors (biliary leakage, bleeding) was 9 %. Actuarial recipient survival was 93 % after three months and 88 % after one year. Five patients had to be re-transplanted. Thus the actuarial 1-year graft survival was 79 %. Biliary complications occurred in 14 % of all recipients.
According to our experience, living donor liver transplantation of the right hepatic lobe is a safe and effective procedure. Especially for patients in acute and chronic liver failure, who otherwise would have died on the waiting list, this approach offers a life-saving option.
在过去几年中,越来越多的移植中心开展了成人活体肝移植。供体的安全性和风险是影响其进一步发展的重要因素。我们报告了43例成人对成人右半肝活体肝移植的经验。
1999年12月至2001年12月期间,43例终末期肝病患者(平均年龄:49.8±16.0岁;女∶男 = 14∶29)接受了来自成人活体供体(平均年龄:42.4±13.4岁;女∶男 = 27∶16)的右半肝移植。在项目启动和每次捐赠前均获得了当地伦理委员会的批准。
所有供体均未发生致命或长期并发症。供体的手术并发症(胆漏、出血)发生率为9%。术后3个月的受者实际生存率为93%,1年后为88%。5例患者需要再次移植。因此,1年的移植物实际生存率为79%。14%的受者发生了胆道并发症。
根据我们的经验,右半肝活体肝移植是一种安全有效的手术。特别是对于急性和慢性肝衰竭患者,否则他们将在等待名单上死亡,这种方法提供了一种挽救生命的选择。