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孕妇活体供肝切除术。

Living donor hepatectomy in a pregnant woman.

作者信息

Lin Chih-Che, Chen Chao-Long, de Villa Vanessa H, Chen Yaw-Sen, Wang Chih-Chi, Wang Shih-Hor, Cheng Yu-Fan, Huang Tung-Liang, Hsu Te Yao

机构信息

Liver Transplant Program, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center Kaohsiung, Taiwan.

出版信息

Hepatogastroenterology. 2007 Mar;54(74):539-40.

Abstract

Liver transplantation with a live donor is an effective way to expand the donor pool. Restrictive selection of living donors may assure donor safety but limit the utility of this resource. A 12-month-old recipient with biliary atresia was rapidly deteriorating with hepatic encephalopathy, massive ascites and coagulopathy. Her mother, the only possible living donor, expressed a strong desire to donate part of liver to her baby, although she was found to be pregnant. The donor hepatectomy was then undertaken at 18 weeks of gestation. A left lateral segmentectomy was performed. Her postoperative course was uneventful and she was discharged 7 days after the operation. She gave birth to a healthy term baby without any complications 5 months later. Both recipient and her younger brother are well 12 months after the operation. Despite the limited experience reported herein, pregnancy may no longer be considered an absolute contraindication for live liver donation.

摘要

活体供肝肝移植是扩大供体来源的有效途径。对活体供体进行严格筛选可确保供体安全,但会限制这种资源的利用。一名12个月大的胆道闭锁受者因肝性脑病、大量腹水和凝血功能障碍而病情迅速恶化。她的母亲是唯一可能的活体供体,尽管被发现怀有身孕,但仍强烈希望为自己的宝宝捐献部分肝脏。然后在妊娠18周时进行了供肝切除术。实施了左外叶肝段切除术。她术后恢复顺利,术后7天出院。5个月后,她生下了一个健康的足月婴儿,没有任何并发症。术后12个月,受者和她的弟弟都状况良好。尽管本文报道的经验有限,但妊娠可能不再被视为活体肝捐献的绝对禁忌证。

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