González I, Abdo A A, López O, Hernández J C, Samada M, Cepero M, Ramos L, Ysla R, Madrigal G, Collera S A, Dominguez J, Diaz J, Benitez P P, Castellanos R
Centro de Investigaciones Médico Quirúrgicas, Havana, Cuba.
Transplant Proc. 2006 Oct;38(8):2473-4. doi: 10.1016/j.transproceed.2006.08.088.
In July 1999 we began a liver transplant program that to October 2005 has included 100 liver transplants in 92 patients, eight retransplants, and two combined liver and kidney grafts. Twelve transplants were in pediatric patients, who showed a 92% survival rate in the first year. Fifty-four percent of the patients were male and 46% female. The most frequent etiologies of cirrhosis were 27% hepatitis virus C, 18% alcoholic, 13% cryptogenic, and 11% autoimmune. In 95% of the patients, we preserved the retrohepatic vena cava. The bile duct was reconstructed with a Kehr tube in 46% of patients with 31% using end-to-end suture with a tutor and 15% an end-to-end suture without a tutor. A hepaticojejunostomy was performed in 8%. The immunosuppression included cyclosporine (Neoral) or Prograf combined with mycophenolate mofetil or mycophenolate sodium and steroids. The most frequent biliary complications were local anastomosis leaks (6%) and stenosis (10%). The overall 1-year survival rate was 72%.
1999年7月，我们启动了一项肝移植项目，截至2005年10月，该项目已为92名患者进行了100例肝移植手术，其中包括8例再次移植手术以及2例肝肾联合移植手术。12例移植手术的患者为儿童，其第一年的生存率为92%。患者中男性占54%，女性占46%。肝硬化最常见的病因依次为：丙型肝炎病毒感染（27%）、酒精性（18%）、隐源性（13%）和自身免疫性（11%）。95%的患者保留了肝后下腔静脉。46%的患者采用Kehr管重建胆管，31%的患者采用带支撑管的端端吻合术，15%的患者采用无支撑管的端端吻合术。8%的患者进行了肝空肠吻合术。免疫抑制方案包括环孢素（新山地明）或普乐可复联合霉酚酸酯或麦考酚钠以及类固醇。最常见的胆道并发症为局部吻合口漏（6%）和狭窄（10%）。总体1年生存率为72%。
