Nishida S, Vaidya A, Kato T, Nakamura N, Madariaga J, Tzakis A
Division of Transplantation, Department of Surgery, University of Miami, School of Medicine, Miami, Florida, USA.
Br J Surg. 2004 Jun;91(6):705-8. doi: 10.1002/bjs.4550.
Arterial reconstruction remains the most important technical issue in paediatric transplantation. The arteries of paediatric donors as well as recipients are small and friable. The aim of this study was to assess the use of the donor aorta as a conduit for arterial reconstruction in paediatric liver and multivisceral transplantation.
Between June 1994 and January 2002, 284 paediatric transplants, including 197 cadaveric liver and multivisceral transplants, were performed in children at this centre. Of these, 41 (20.8 per cent), including nine cadaveric liver transplants and 32 multivisceral transplants, were revascularized by donor aortic reconstruction. Patient demographics, types of donor arterial reconstruction, technical complications and incidence of hepatic artery thrombosis were reviewed.
None of the 41 donor aortic reconstructions used in revascularization of paediatric liver and multivisceral transplants thrombosed. There were no bleeding complications and no pseudoaneurysms developed.
Arterial reconstruction using donor aorta is a useful option with a low incidence of thrombosis in paediatric transplantation.
动脉重建仍然是小儿移植中最重要的技术问题。小儿供体以及受体的动脉细小且脆弱。本研究的目的是评估使用供体主动脉作为小儿肝移植和多脏器移植中动脉重建的管道。
1994年6月至2002年1月期间,本中心为儿童实施了284例小儿移植手术,其中包括197例尸体肝移植和多脏器移植。其中41例(20.8%),包括9例尸体肝移植和32例多脏器移植,通过供体主动脉重建进行了血管重建。回顾了患者的人口统计学资料、供体动脉重建类型、技术并发症以及肝动脉血栓形成的发生率。
用于小儿肝移植和多脏器移植血管重建的41例供体主动脉重建均未发生血栓形成。没有出血并发症,也没有形成假性动脉瘤。
在小儿移植中,使用供体主动脉进行动脉重建是一种有用的选择,血栓形成发生率较低。