[肝脏再次移植：80例报告]
[Liver retransplantation: report of 80 cases].
作者信息
Shen Zhong-yang, Zhu Zhi-jun, Deng Yong-lin, Zheng Hong, Pan Cheng, Zhang Ya-min, Shi Rui, Jiang Wen-tao, Zhang Jian-jun
机构信息
Transplant Center, Tianjing First Central Hospital, Tianjin 300192, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2006 Mar 1;44(5):298-301.
OBJECTIVE
To sum up the clinical experience of liver retransplantation.
METHODS
The clinical data of patients receiving liver retransplantation in our department between Jan. 1999 and July 2005 were retrospectively analyzed, the cause of retransplantation, timing of retransplantation, technical considerations and the causes of death.
RESULTS
The most common causes of hepatic graft loss and subsequent retransplantation are biliary complications (45.0%). Patients who received retransplantation more than 30 days after their initial transplant fared better than those who received retransplants between 8 and 30 days after receiving their first one (intraoperative mortality rates 19.6% versus 70.0%). The development of sepsis (54.5%) and multiorgan failure (18.2%) accounts for the majority of deaths in retransplanted patients.
CONCLUSIONS
Proper indication and optimum operation time, surgical procedure, perioperative monitoring and proper treatment post operation contribute to the increase of the survival rate of the patients receiving liver retransplantation.
目的
总结肝脏再次移植的临床经验。
方法
回顾性分析1999年1月至2005年7月在我科接受肝脏再次移植患者的临床资料，包括再次移植的原因、时机、技术要点及死亡原因。
结果
肝移植失败及随后再次移植最常见的原因是胆道并发症（45.0%）。初次移植后30天以上接受再次移植的患者比初次移植后8至30天接受再次移植的患者情况更好（术中死亡率分别为19.6%和70.0%）。脓毒症（54.5%）和多器官功能衰竭（18.2%）是再次移植患者死亡的主要原因。
结论
合适的适应证、最佳手术时机、手术操作、围手术期监测及术后恰当治疗有助于提高肝脏再次移植患者的生存率。
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