活体肝移植后静脉曲张出血的经颈静脉肝内门体分流术：一个危险指征。
TIPSS for variceal hemorrhage after living related liver transplantation: a dangerous indication.
作者信息
Schemmer Peter, Radeleff Boris, Flechtenmacher Christa, Mehrabi Arianeb, Richter Gotz M, Buchler Markus W, Schmidt Jan
机构信息
Department of General Surgery, Ruprecht-Karls-University, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
出版信息
World J Gastroenterol. 2006 Jan 21;12(3):493-5. doi: 10.3748/wjg.v12.i3.493.
The introduction of transjugular intrahepatic portal-systemic stent-shunt (TIPSS) has been a major breakthrough in the treatment of portal hypertension, which has evolved to a large extent, into a routine procedure. A 21-year-old male patient with progressive graft fibrosis/cirrhosis requiring TIPSS for variceal hemorrhage in the esophagus due to portal hypertension was unresponsive to conventional measures two years after living related liver transplantation (LDLT). Subsequently, variceal hemorrhage was controlled, however, liver function decreased dramatically with consecutive multi organ failure. CT scan revealed substantial necrosis in the liver. The patient underwent successful "high urgent" cadaveric liver transplantation and was discharged on postoperative d 20 in a stable condition.
经颈静脉肝内门体分流术（TIPSS）的引入是门静脉高压治疗的一项重大突破，该技术在很大程度上已发展成为一种常规手术。一名21岁男性患者，因门静脉高压导致食管静脉曲张出血，在活体亲属肝移植（LDLT）两年后，出现进行性移植肝纤维化/肝硬化，对传统治疗措施无反应。随后，静脉曲张出血得到控制，但肝功能急剧下降，并连续出现多器官功能衰竭。CT扫描显示肝脏有大量坏死。该患者成功接受了“紧急”尸体肝移植，并于术后第20天病情稳定出院。
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