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为一名患有胆道闭锁的婴儿进行活体亲属肝移植。

Living related liver transplantation for an infant with biliary atresia.

作者信息

Zheng Shu-Sen, Huang Dong-Sheng, Wang Wei-Lin, Liang Ting-Bo, Zhang Min, Shen Yan, Lu An-Wei, Liao Sheng-Yang, Xu Xiao

机构信息

Department of General Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2002 May;1(2):172-5.

Abstract

OBJECTIVE

To sum up the preliminary experience in living related liver transplantation (LRLT).

METHODS

A 9-month-old male infant with biliary atresia (BA) who had undergone an unsuccessful Kasai operation was defined as a candidate for LRLT. The donor was his 30-year-old mother. Her lateral lobe of the left liver was transplanted into the infant's body as the graft. The left branches of the portal vein, left hepatic artery and left hepatic vein of the graft were end-to-end anastomosed to the portal vein, hepatic artery proper and hepatic vein of the recipient respectively. Biliary drainage was reestablished via Roux-en-Y operation.

RESULTS

The donor retained her liver function within 2 weeks after the operation. Steroid and FK506 were prescribed in immunosuppressive therapy for the recipient. The blood bilirubin level of the infant decreased to normal 2 weeks after operation. No acute rejection occurred. Biliary leakage in the early period after the transplantation was controlled by drainage, and E.coli infection was effectively treated with antibiotics. The donor and recipient are in satisfactory condition to the present.

CONCLUSION

LRLT is advisable for children with biliary atresia.

摘要

目的

总结亲属活体肝移植(LRLT)的初步经验。

方法

一名9个月大的患有胆道闭锁(BA)且Kasai手术失败的男婴被确定为LRLT候选者。供体为其30岁的母亲。将供体的左肝外侧叶作为移植物移植到婴儿体内。移植物的门静脉左支、肝左动脉和肝左静脉分别与受体的门静脉、肝固有动脉和肝静脉进行端端吻合。通过Roux-en-Y手术重建胆道引流。

结果

供体术后2周内肝功能维持正常。受体免疫抑制治疗采用类固醇和FK506。婴儿术后2周血胆红素水平降至正常。未发生急性排斥反应。移植术后早期的胆漏通过引流得到控制,大肠杆菌感染通过抗生素得到有效治疗。目前供体和受体情况良好。

结论

亲属活体肝移植对胆道闭锁患儿是可取的。

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