Housari G, Nuño J, Calero P, López-Buenadicha A, Peromingo R, Díe-Trill J, López-Hervás P
Department of Surgery,Hospital Universitario Ramón y Cajal, Spain.
Transplant Proc. 2011 Apr;43(3):755-7. doi: 10.1016/j.transproceed.2011.01.085.
We report a 66-year-old woman who underwent emergency orthotopic liver transplantation due to acute liver failure. The donor's liver graft displayed extensive arteriosclerosis, involving the celiac trunk and hepatic artery. Arterial revascularization of the graft could not be achieved, requiring an arterioportal shunt between the gastroduodenal artery and the portal vein of the recipient. During the early postoperative period, the patient's clinical condition and liver function tests improved rapidly; the patient was discharged on postoperative day 30. Two months later, she developed acute cholangitis. Ischemic-type stenosis of the intrahepatic biliary tree was present, so successful elective retransplantation was undertaken at the ninth postoperative month. In our experience, portal vein arterialization may be useful as a bridging therapy in extreme situations.
我们报告了一名66岁的女性，她因急性肝衰竭接受了急诊原位肝移植。供体肝脏移植物显示出广泛的动脉硬化，累及腹腔干和肝动脉。无法实现移植物的动脉血管重建，需要在胃十二指肠动脉和受体门静脉之间进行动门分流。术后早期，患者的临床状况和肝功能检查迅速改善；患者于术后第30天出院。两个月后，她发生了急性胆管炎。存在肝内胆管树的缺血型狭窄，因此在术后第九个月进行了成功的择期再次移植。根据我们的经验，门静脉动脉化在极端情况下可能作为一种桥接治疗方法有用。
