Wakayama Kenji, Jin Maeng Bong, Furukawa Hiroyuki, Todo Satoru, Shimamura Tsuyoshi, Suzuki Tomomi, Hattori Masahiro, Yokoyama Ryouji, Iwasaki Sari, Sato Masanori, Nakagawa Takahito, Kurauchi Noriaki, Kamachi Hirohumi, Kamiyama Toshiya, Matsushita Michiaki
First Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
J Hepatobiliary Pancreat Surg. 2004;11(6):445-8. doi: 10.1007/s00534-004-0925-4.
The first case of domino liver transplantation from a brain-dead donor in Japan is described. A 49-year-old man with familial amyloidotic polyneuropathy received a cadaver liver, and his native liver was transplanted into a 53-year-old man with polycystic liver and kidney disease. The cadaveric liver allograft was transplanted by the conventional technique. The graft taken from the first recipient had four outflow orifices (the left, middle, and right hepatic veins, and upper vena cava), for which a single orifice was created at the back table. This graft was transplanted in piggy-back fashion. The first recipient developed acute rejection on day 13 and hepatic artery stenosis on day 36. These were treated by steroid recycle therapy and percutaneous transarterial angioplasty. He was discharged on day 57 with normal liver function. The second recipient underwent re-operation for bleeding from the right adrenal gland and left thoracic cavity. He was diagnosed with acute rejection on day 7, which was treated by steroid pulse therapy. He was discharged uneventfully on day 39 with normal liver function.
本文描述了日本首例来自脑死亡供体的多米诺肝移植病例。一名患有家族性淀粉样多神经病的49岁男性接受了尸体肝脏移植，其自身肝脏被移植给一名患有多囊肝和多囊肾病的53岁男性。尸体肝脏同种异体移植采用传统技术。取自首位受者的移植物有四个流出孔（肝左、中、右静脉和上腔静脉），在后台手术中为其创建了一个单一的流出孔。该移植物采用背驮式移植。首位受者在术后第13天发生急性排斥反应，第36天出现肝动脉狭窄。这些情况通过类固醇再循环疗法和经皮经动脉血管成形术进行治疗。他在术后第57天出院，肝功能正常。第二位受者因右肾上腺和左胸腔出血接受了再次手术。他在术后第7天被诊断为急性排斥反应，通过类固醇冲击疗法进行治疗。他在术后第39天顺利出院，肝功能正常。
