原位肝移植术后肝动脉血栓形成的肝动脉重建术。
Hepatic artery reconstruction for hepatic artery thrombosis after orthotopic liver transplantation.
作者信息
Yanaga K, Lebeau G, Marsh J W, Gordon R D, Makowka L, Tzakis A G, Todo S, Stieber A C, Iwatsuki S, Starzl T E
机构信息
Department of Surgery, University of Pittsburgh School of Medicine, PA 15213.
出版信息
Arch Surg. 1990 May;125(5):628-31. doi: 10.1001/archsurg.1990.01410170076016.
We evaluated the efficacy of reconstruction of the hepatic artery for intraoperative or postoperative thrombosis in orthotopic liver transplantation. Of 37 grafts with artery thrombosis, 13 (35.1%, 6 intraoperative and 7 postoperative) underwent reconstruction of the hepatic artery. The arterial flow was reestablished and maintained in 5 (38.5%) of the 13. Recurrent thrombosis in the other 8 grafts developed 2 to 24 days (mean, 13.8 days) after transplantation. Reconstruction was successful in 50% (4/8) of the adults, compared with only 20% (1/5) of the children. Satisfactory results were obtained when a definitive cause of thrombosis could be identified. We conclude that early recognition and correction of the cause of hepatic artery thrombosis during or after orthotopic liver transplantation, especially in adults, is often a graft-saving and lifesaving procedure worthy of consideration.
我们评估了原位肝移植术中或术后肝动脉血栓形成后肝动脉重建的疗效。在37例发生动脉血栓形成的移植肝中，13例（35.1%，术中6例，术后7例）接受了肝动脉重建。13例中有5例（38.5%）重建后动脉血流得以重建并维持。其余8例移植肝在移植后2至24天（平均13.8天）出现复发性血栓形成。成人患者重建成功的比例为50%（4/8），而儿童患者仅为20%（1/5）。当能够确定血栓形成的确切原因时，可获得满意的结果。我们得出结论，原位肝移植术中或术后早期识别并纠正肝动脉血栓形成的原因，尤其是在成人患者中，通常是一种值得考虑的挽救移植肝和挽救生命的手术。
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