Abdullah K, Abdeldayem H, Hali W O, Sakran A, Yassen K, Abdulkareem A
Department of Hepatobiliary Science and Liver Transplantation, King Abdul Aziz Medical City, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
Transplant Proc. 2005 Sep;37(7):3144-6. doi: 10.1016/j.transproceed.2005.07.056.
The deceased donor organ shortage has forced surgeons to implement innovations, including living-related liver transplantation (LRLT).
To present the first 20 cases of adult LRLT in a single center in Saudi Arabia.
From November 2000 to May 2004, we performed 20 cases of LRLT. Eighteen donors were men and 2 were women. Their median age was 27 years. Seventeen of the recipients were men and 3 were women of median age 55 years. One patient received combined liver and kidney grafts.
All cases had liver cirrhosis. Seven had hepatitis C; six, hepatitis B and C; three, hepatitis B; one, alcoholic cirrhosis; one, Bylar disease, one hepatic schistosomiasis, and one cryptogenic cirrhosis. Three cases had associated hepatocellular carcinomas. There was no donor mortality. In the recipients, the overall patient and graft survival was 85%. While 10 donors presented uneventful postoperative courses, 8 experienced minor complications and 2, major complications: biliary stricture and portal vein thrombosis. Recipients complications included biliary complications (35%), acute rejection (20%), hepatitis C reactivation (20%), hepatic vein stenosis (10%), hepatic artery stenosis (5%), and hepatocellular carcinoma recurrence (5%).
LRLT has become a standard option in adults with end-stage liver failure in our center.
已故供体器官短缺迫使外科医生进行创新,包括亲属活体肝移植(LRLT)。
介绍沙特阿拉伯单中心首例20例成人亲属活体肝移植情况。
2000年11月至2004年5月,我们实施了20例亲属活体肝移植。18名供体为男性,2名供体为女性。他们的中位年龄为27岁。17名受体为男性,3名受体为女性,中位年龄55岁。1例患者接受了肝肾联合移植。
所有病例均为肝硬化。7例为丙型肝炎;6例为乙型和丙型肝炎;3例为乙型肝炎;1例为酒精性肝硬化;1例为比拉尔病,1例为肝血吸虫病,1例为隐源性肝硬化。3例伴有肝细胞癌。无供体死亡。在受体中,总体患者和移植物存活率为85%。10名供体术后过程顺利,8名出现轻微并发症,2名出现严重并发症:胆管狭窄和门静脉血栓形成。受体并发症包括胆管并发症(35%)、急性排斥反应(20%)、丙型肝炎复发(20%)、肝静脉狭窄(10%)、肝动脉狭窄(5%)和肝细胞癌复发(5%)。
在我们中心,亲属活体肝移植已成为终末期肝衰竭成人患者的标准选择。