Wang Qiao, Yan Lunan, Zhang Mingman, Wang Wentao, Zhao Jichun, Jin Shuguang
Hepatogastroenterology. 2013 Jun;60(124):807-12. doi: 10.5754/hge12956. Epub 2013 Jan 9.
BACKGROUND/AIMS: The outcome of the Kasai operation remains unsatisfying. This study aims to evaluate the feasibility and effectiveness of primary LDLT on biliary atresia (BA) treatment for infant patients.
Fifty infant patients with BA who were treated in our center between Jan 2008-Jan 2011 were included. Seventeen of them received LDLT. Another 33 patients received Kasai operation as the first line treatment. All patients had no history of previous abdominal surgery. Records of these patients and the donors for LDLT were retrospectively reviewed.
The follow-up ranged from 12-48.5 months; 30 postoperative-day survival of the LDLT patients and Kasai patients were 82.4% and 81.8%, respectively (p=1). One-year survival of the two groups was 82.4% and 60.6% (p=0.200). Jaundice free rate of the patients who survived at least one month after the surgery was 100% vs. 70.4% of the LDLT group and Kasai group, respectively (p=0.035). Main cause of death in LDLT group was hepatic artery thrombosis and multiple organ dysfunction syndrome in the Kasai group.
Primary LDLT is a safe and efficient management for infant patients with BA. It may serve as an alternative first line treatment for BA treatment with specific indications.
背景/目的：肝门空肠吻合术的疗效仍不尽人意。本研究旨在评估原位肝移植治疗婴儿胆道闭锁（BA）的可行性和有效性。
纳入2008年1月至2011年1月在本中心接受治疗的50例婴儿BA患者。其中17例接受了肝移植。另外33例患者接受肝门空肠吻合术作为一线治疗。所有患者既往均无腹部手术史。对这些患者以及肝移植供体的记录进行回顾性分析。
随访时间为12至48.5个月；肝移植患者和肝门空肠吻合术患者术后30天生存率分别为82.4%和81.8%（p = 1）。两组患者1年生存率分别为82.4%和60.6%（p = 0.200）。术后至少存活1个月的患者无黄疸率分别为100%和70.4%，肝移植组和肝门空肠吻合术组（p = 0.035）。肝移植组的主要死亡原因是肝动脉血栓形成，肝门空肠吻合术组是多器官功能障碍综合征。
原位肝移植是治疗婴儿BA的一种安全有效的方法。对于有特定指征的BA治疗，它可作为一种替代的一线治疗方法。
