Hoffmann Katrin, Weigand Markus A, Hillebrand Norbert, Büchler Markus W, Schmidt Jan, Schemmer Peter
Department of General Surgery, Ruprecht-Karls-University, Heidelberg, Germany.
Clin Transplant. 2009 Jan-Feb;23(1):1-8. doi: 10.1111/j.1399-0012.2008.00897.x.
Orthotopic liver transplantation has been made feasible with intra-operative femoral-to-jugular veno-venous bypass (VVB) to redirect the blood from the lower extremities and the kidneys to the heart. This reduces hemodynamic instability and metabolic disturbances. However, complications such as thromboses with pulmonary thrombembolism or post-reperfusion syndrome were observed in up to 30% of the cases. The latter, recent developments of cava-sparing surgical techniques, shorter anhepatic times plus optimized anesthetic management have made the necessity for a routine use of VVB questionable.
原位肝移植通过术中股静脉至颈静脉静脉转流（VVB）使血液从下肢和肾脏转流至心脏，从而变得可行。这减少了血流动力学不稳定和代谢紊乱。然而，高达30%的病例中观察到了诸如伴有肺血栓栓塞的血栓形成或再灌注综合征等并发症。随着保留腔静脉手术技术的最新发展、无肝期缩短以及麻醉管理的优化，常规使用VVB的必要性受到质疑。
