Abouna G M, Preshaw R M, Silva J L, Hollingsworth W J, Hershfield N B, Novak W, Shaw D T, Vetters J M
Can Med Assoc J. 1976 Oct 9;115(7):615-9.
A 39 year-old patient with cholangiocarcinoma and pre-existing ulcerative colitis was successfully treated by orthotopic liver transplantation. He was given low doses of prednisone and azathioprine and survived for more than 9 months, dying with tumour metastases, thrombosis of the inferior vena cava and an intra-abdominal abscess. At autopsy the homograft showed little evidence of rejection. Preoperatively the patient had septicemia. Removal of his liver was difficult. The discrepancy between donor and recipient in size of blood vessels and the presence of two hepatic arteries in the donor caused problems during the vascular anastomoses. During the operation cardiac arrest occurred. Postoperatively there were several medical and surgical problems, including intraperitoneal and gastrointestinal hemorrhage, paralysis of the right dome of the diaphragm, sinus bradycardia, massive diuresis, peroneal nerve palsy, and one major and three minor episodes of rejection, which were reversed by giving pulse doses of methylprednisolone intravenously.
一名39岁患有胆管癌且合并溃疡性结肠炎的患者通过原位肝移植成功接受治疗。他接受了低剂量的泼尼松和硫唑嘌呤治疗，存活了9个多月，最终死于肿瘤转移、下腔静脉血栓形成和腹腔内脓肿。尸检时，同种异体移植肝几乎没有排斥反应的迹象。术前患者患有败血症。切除他的肝脏很困难。供体和受体血管大小的差异以及供体存在两条肝动脉在血管吻合过程中引发了问题。手术过程中发生了心脏骤停。术后出现了几个医疗和手术问题，包括腹腔内和胃肠道出血、右膈穹窿麻痹、窦性心动过缓、大量利尿、腓总神经麻痹以及一次严重和三次轻微的排斥反应发作，通过静脉注射脉冲剂量的甲泼尼龙使其得到逆转。
