Hawxby Alan M, Mason David P, Klein Andrew S
Department of Surgery, Division of Transplant and Thoracic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
Hepatobiliary Pancreat Dis Int. 2006 Aug;5(3):459-61.
Because of the critical worldwide shortage of cadaveric organ donors, transplant professionals have increasingly turned to living donors. Partial hepatectomy for adult living donor liver transplantation has been performed since the late 1990s. Most often, the complications of living donor hepatectomy have been related to the biliary tract, specifically biliary leaks.
A 54-year-old man underwent donor right hepatectomy for living donor liver transplantation. Three years after liver donation he presented with upper abdominal pain and fullness. Radiographic workup revealed a diaphragmatic hernia of the right hemithorax.
After thoracoscopic evaluation of the right hemithorax, diaphragmatic hernia was repaired. Currently the patient remains well several months after the repair with complete resolution of abdominal pain, normal chest X-ray examination demonstrating no recurrence of diaphragmatic hernia, and normal liver functions tests.
Multiple complications of living donor liver transplantation have been described the transplant literature. Diaphragmatic hernia is a formerly-undescribed complication of right donor hepatectomy for transplantation.
由于全球范围内尸体器官供体严重短缺,移植专业人员越来越多地转向活体供体。自20世纪90年代末以来,已开展了成人活体供体肝移植的部分肝切除术。活体供体肝切除术的并发症大多与胆道有关,尤其是胆漏。
一名54岁男性接受了活体供体肝移植的供体右肝切除术。肝移植三年后,他出现上腹部疼痛和饱胀感。影像学检查发现右半胸膈疝。
经胸腔镜评估右半胸后,修复了膈疝。目前,患者在修复术后数月情况良好,腹痛完全缓解,胸部X线检查正常,未显示膈疝复发,肝功能检查正常。
移植文献中描述了活体供体肝移植的多种并发症。膈疝是右供体肝移植肝切除术以前未被描述的并发症。