活体肝移植治疗暴发性肝衰竭。
Living donor liver transplantation for fulminant hepatic failure.
机构信息
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
出版信息
Hepatol Res. 2008 Oct;38(10):987-96. doi: 10.1111/j.1872-034X.2008.00372.x. Epub 2008 Jun 28.
AIM
The aim of this study was to investigate the safety of living donor liver transplantation (LDLT) for fulminant hepatic failure (FHF) patients.
METHODS
We reviewed the clinical indications, operative procedures and prognosis of LDLT performed on patients with FHF at the University of Tokyo. From January 1996 to August 2007, 96 patients were referred to our department due to severe acute hepatitis or FHF. Of these, 36 underwent LDLT and were the subjects of this study. Of the 36 patients who underwent LDLT, 32 were over 18 years old. The etiologies of FHF included non-A, non-B hepatitis in 23, hepatitis B virus in 11, Wilson's disease in one, and auto-immune hepatitis in one. Graft type included right liver in 18, left liver in 16 and right paramedian sector in two.
RESULTS
Patient and graft survival rates at 5 years were 87% and 82%, respectively. Twenty-three patients had postoperative complications: acute cellular rejection in 12, biliary stricture in eight, bile leakage in six, peritoneal hemorrhage in six and hepatic arterial thrombosis in four.
CONCLUSION
The LDLT procedure provided satisfactory survival rates for FHF patients.
目的
本研究旨在探讨活体肝移植（LDLT）治疗暴发性肝衰竭（FHF）患者的安全性。
方法
我们回顾了东京大学为 FHF 患者行 LDLT 的临床适应证、手术过程和预后。1996 年 1 月至 2007 年 8 月，96 例因严重急性肝炎或 FHF 而转至我院。其中 36 例行 LDLT，为本研究对象。36 例行 LDLT 的患者中，32 例年龄大于 18 岁。FHF 的病因包括非 A、非 B 型肝炎 23 例，乙型肝炎病毒 11 例，Wilson 病 1 例，自身免疫性肝炎 1 例。移植物类型包括右肝 18 例，左肝 16 例，右旁正中叶 2 例。
结果
5 年患者和移植物存活率分别为 87%和 82%。23 例患者术后发生并发症：急性细胞排斥 12 例，胆管狭窄 8 例，胆漏 6 例，腹腔出血 6 例，肝动脉血栓形成 4 例。
结论
LDLT 术为 FHF 患者提供了满意的生存率。
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