Darwish Ahmed A, Bourdeaux Christophe, Kader Hesham A, Janssen Magda, Sokal Etienne, Lerut Jan, Ciccarelli Olga, Veyckemans Francis, Otte Jean-Bernard, de Goyet Jean de Ville, Reding Raymond
Pediatric Liver Transplantation Program, Saint-Luc University Clinics, Université catholique de Louvain, Brussels, Belgium.
Pediatr Transplant. 2006 May;10(3):345-53. doi: 10.1111/j.1399-3046.2005.00477.x.
Living-related liver transplantation was developed in the context of deceased donor organ shortage, which is particularly acute for pediatric recipients. This retrospective study analyzes the surgical technique and complications in the first 100 pediatric liver transplantation using left segmental liver grafts from living donors, performed at Saint-Luc University Clinics between July 1993 and April 2002. Pre-operative evaluation in donors and recipients, analysis of the surgical technique, and postoperative complications were reviewed. After a median follow-up period of 2526 days, no donor mortality was encountered, with a minimal morbidity and no long-term sequelae. At one and five yr post-transplantation, the actuarial patient survival rates were 94% and 92%, the corresponding figures being 92% and 89% for graft survival. The incidences of portal vein and hepatic artery thromboses, and of biliary complications were 14%, 1%, and 27%, respectively. Living-related liver transplantation in children constitutes an efficient therapy for liver failure to face the increased demand for liver grafts. Donor morbidity was kept to acceptable incidence, and surgical technique in the recipient needs to be tailored to minimize postoperative complications.
活体亲属肝移植是在尸体供肝短缺的背景下发展起来的，这一问题在儿童受者中尤为突出。本回顾性研究分析了1993年7月至2002年4月在圣吕克大学诊所进行的首例100例使用活体供者左半肝移植的小儿肝移植的手术技术及并发症。回顾了供者和受者的术前评估、手术技术分析及术后并发症。中位随访期2526天后，未发生供者死亡，发病率极低且无长期后遗症。移植后1年和5年，患者的精算生存率分别为94%和92%，移植物生存率分别为92%和89%。门静脉和肝动脉血栓形成以及胆道并发症的发生率分别为14%、1%和27%。儿童活体亲属肝移植是应对肝移植需求增加的一种有效治疗肝衰竭的方法。供者发病率保持在可接受的范围内，受者的手术技术需要进行调整以尽量减少术后并发症。
