Savio-López Andrés M, Lara-Molina Evelin E, Soliva-Domínguez Ramón, Capo-Jorge José A, Gala-López Boris, González-Castillo Fernando
Unidad de Trasplantes, Hospital Clínico-Quirúrgico Hermanos Ameijeiras, La Habana, Cuba.
Cir Cir. 2005 Nov-Dec;73(6):481-4.
Hepatic retransplant constitutes 10-20% of all orthotopic hepatic transplants. The piggy-back technique was used in hepatectomy with conservation of the retrohepatic vena cava. A side-to-side cavo-cavostomy technique is described in the case of hepatic congestion or acute Budd Chiari syndrome post-transplant. This is an extremely serious condition and can result in death. We present the first case of hepatic retransplant performed in Hospital Hermanos Ameijeiras in a patient who received who received his first transplant due to non-resectable hepatocarcinoma and who required retransplant due to acute rejection and graft dysfunction. During retransplant, the Belghiti side-to-side anastomosis technique was used to resolve the acute Budd Chiari syndrome that presented itself. Post-surgical evolution at 18 months was satisfactory without evidence of complications of the graft. Acute Budd Chiari syndrome post-transplant can satisfactorily be resolved with the Belghiti technique, although it is preferable to take prophylactic measures to avoid it.
肝再次移植占所有原位肝移植的10% - 20%。肝切除术采用背驮式技术，保留肝后下腔静脉。对于移植后肝淤血或急性布加综合征的情况，描述了一种端侧腔静脉吻合技术。这是一种极其严重的情况，可导致死亡。我们介绍了在何塞·阿梅吉拉斯兄弟医院进行的首例肝再次移植病例，该患者因不可切除的肝癌接受了首次移植，后因急性排斥反应和移植物功能障碍而需要再次移植。在再次移植过程中，采用了贝尔吉蒂端侧吻合技术来解决出现的急性布加综合征。术后18个月的病情进展令人满意，未发现移植物并发症的迹象。移植后急性布加综合征采用贝尔吉蒂技术可得到满意解决，不过最好采取预防措施以避免其发生。
