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[活体供肝肝移植,成人对成人]

[Living donor liver transplantation, adult to adult].

作者信息

Pinna A, Masetti M, Miller C, Dazzi A, Begliomini B, Siniscalchi A, Cautero N, Di Benedetto F, Lauro A, Girardis M, Villa E, Ramacciato G

机构信息

Centro Trapianti di Fegato e Multiviscerale, Università degli Studi di Modena e Reggio Emilia, Modena e Reggio Emilia, Italy.

出版信息

Minerva Chir. 2003 Oct;58(5):657-73.

Abstract

AIM

Since living donor liver transplantation (LDLT) can offer a viable response to the lack of transplantable cadaveric organs, our center instituted an LDLT program in 2001.

METHODS

The authors report their experience with the first 35 LDLT procedures successfully completed at the Liver and Multiorgan Transplant Center of the University of Modena between 9 May 2001 and 21 May 2003. The case series comprised 35 patients, 7 of which received a left-half liver and 1 a left lobe.

RESULTS

The global survival rate was 77.2% (27 out of 35 patients), with a mean follow-up period of 295 days; the survival rate at 1 year was 81%. In 4 cases (11%) retransplantation was performed. The donor demographics are described; all donors returned to their normal activities before transplantation, after a mean follow-up period of 373 days. No intraoperative complications were experienced by the donors, whereas during the postoperative period, 2 donors (5.7%) developed major complications (1 biliary fistula on the cut surface, 1 stenosis of the main bile duct).

CONCLUSION

Our study shows that LDLT can be safely completed in the donor, with good results achieved in the recipient as well. Underlying these results is the accurate pretransplant assessment that continued into the operation itself. Even more important was the demonstrated ability and experience of the surgical team to attain results in the donor which we believe are necessary for carrying forth a LDLT program.

摘要

目的

鉴于活体供肝移植(LDLT)能够为可移植尸体器官短缺问题提供切实可行的应对方案,我们中心于2001年启动了一项LDLT项目。

方法

作者报告了2001年5月9日至2003年5月21日期间在摩德纳大学肝脏和多器官移植中心成功完成的首例35例LDLT手术的经验。该病例系列包括35例患者,其中7例接受了左半肝移植,1例接受了左外叶移植。

结果

总体生存率为77.2%(35例患者中的27例),平均随访期为295天;1年生存率为81%。4例(11%)患者接受了再次移植。描述了供体的人口统计学特征;所有供体在平均373天的随访期后,在移植前恢复了正常活动。供体术中无并发症发生,而在术后,2例供体(5.7%)出现了严重并发症(1例切面胆瘘,1例主胆管狭窄)。

结论

我们的研究表明,LDLT在供体中能够安全完成,受体也能取得良好效果。这些结果的背后是准确的移植前评估,该评估持续到手术过程中。更重要的是手术团队所展示的能力和经验,能够在供体身上取得我们认为开展LDLT项目所必需的结果。

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