Renz J F, McDiarmid S V, Edelstein S, Yersiz H, Hisatake G M, Gordon S, Saggi B H, Busuttil R W, Farmer D G
Center for Liver Disease and Transplantation, College of Physicians and Surgeons of Columbia University, New York-Presbyterian Hospital, New York, NY 10032, USA.
Transplant Proc. 2004 Mar;36(2):314-5. doi: 10.1016/j.transproceed.2003.12.016.
Liver-intestinal transplantation is a complex surgical procedure that historically has required prolonged operative periods. This report is the first series where liver-intestinal transplantation was performed as a staged procedure. Specifically, allograft reperfusion was followed by resuscitation and stabilization in an intensive care unit before completion of the transplant procedure. Triage of recipients to the intensive care unit following allograft reperfusion was determined at the time of operation and was based upon the clinical condition of the recipient including hemodynamic stability, evidence of coagulopathy, and assessment of early liver function. Medical stabilization was followed by completion of the transplant procedure and definitive abdominal closure within 72 hours. The application of combined liver-intestinal transplantation as a staged procedure demonstrated no effect upon early graft function, incidence of complications, or ability to perform a definitive abdominal closure.
肝肠联合移植是一种复杂的外科手术，从历史上看，该手术需要较长的手术时间。本报告是首次将肝肠联合移植作为分期手术进行的系列报道。具体而言，在移植手术完成前，先进行同种异体移植器官再灌注，然后在重症监护病房进行复苏和稳定治疗。同种异体移植器官再灌注后将受体分诊至重症监护病房是在手术时确定的，并且基于受体的临床状况，包括血流动力学稳定性、凝血功能障碍的证据以及早期肝功能评估。在进行医疗稳定治疗后，在72小时内完成移植手术并进行确定性的腹部闭合。将肝肠联合移植作为分期手术应用对早期移植物功能、并发症发生率或进行确定性腹部闭合的能力没有影响。
