Chen C-L, Concejero A, Wang C-C, Wang S-H, Lin C-C, Liu Y-W, Yong C-C, Yang C-H, Lin T-S, Chiang Y-C, Jawan B, Huang T-L, Cheng Y-F, Eng H-L
Liver Transplantation Program and Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan.
Am J Transplant. 2006 Nov;6(11):2672-9. doi: 10.1111/j.1600-6143.2006.01528.x. Epub 2006 Aug 25.
The aim of this study is to present our institutional experience in living donor liver transplantation (LDLT) as a treatment for end-stage liver disease in children with biliary atresia (BA). A retrospective review of transplant records was performed. One hundred BA patients (52 males and 48 females) underwent LDLT. The mean follow-up period was 85.5 months. The mean age was 2.4 years. The mean preoperative weight, height, and computed GFR were 12.2 kg, 82.5 cm, and 116.4 ml/min/1.73 m2, respectively. Twenty-seven patients were below 1 year of age, and 49 patients were below 10 kg at the time of transplantation. Ninety-six had had previous Kasai operation prior to transplant. The mean recipient operative time was 628 min. The mean recipient intraoperative blood loss was 176 ml. Thirty-five did not require blood or blood component transfusion. The left lateral segment (64) was the most common type of graft used. There were 27 operative complications which included 3 reoperations for postoperative bleeding, 9 portal vein, 4 hepatic vein, 4 hepatic artery, and 7 biliary complications. There was one in-hospital mortality and one retransplantation. The overall rejection rate was 20%. The overall mortality rate was 3%. The 6-month, 1-year and 5-year actual recipient survival rates were 99%, 98% and 98%, respectively.
本研究的目的是介绍我们机构开展活体肝移植(LDLT)治疗胆道闭锁(BA)患儿终末期肝病的经验。对移植记录进行了回顾性分析。100例BA患者(52例男性,48例女性)接受了LDLT。平均随访时间为85.5个月。平均年龄为2.4岁。术前平均体重、身高和计算的肾小球滤过率分别为12.2kg、82.5cm和116.4ml/min/1.73m²。27例患者年龄小于1岁,49例患者移植时体重小于10kg。96例患者在移植前曾接受过Kasai手术。受体平均手术时间为628分钟。受体术中平均失血量为176ml。35例患者无需输血或血液成分输血。左外侧叶(64例)是最常用的移植类型。有27例手术并发症,包括3例术后出血再次手术、9例门静脉、4例肝静脉、4例肝动脉和7例胆道并发症。有1例住院死亡和1例再次移植。总体排斥率为20%。总体死亡率为3%。受体6个月、1年和5年的实际生存率分别为99%、98%和98%。