Dai Wing Chiu, Sharr William W, Chok Kenneth S H, Cheung Tan To, Fung James Y Y, Chan Albert C Y, Chan See Ching, Lo Chung Mau
Department of Surgery, The University of Hong Kong, Hong Kong, China.
State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China; Department of Medicine, The University of Hong Kong, Hong Kong, China.
Asian J Surg. 2015 Apr;38(2):113-6. doi: 10.1016/j.asjsur.2012.09.005. Epub 2013 Jan 23.
The suitable size of a graft is a key element in the success of liver transplantation. A small-for-size liver graft is very likely to sustain a significant degree of injury as a result of ischemia, preservation, reperfusion, and rejection. Usually, small-for-size grafts are a concern in living-donor liver transplantation rather than in deceased-donor liver transplantation. Here, we describe the successful transplantation of a liver from a 2-year-old deceased donor to a 61-year-old male recipient who suffered from liver failure related to hepatitis B. No report of successful deceased-donor liver transplantation with discrepancies between donor and recipient age and size to such an extent has been found in the literature. Despite unusually large discrepancies, with effort in minimizing the ischemic time, revised surgical techniques, and strong regenerative power of the "young" graft, the old patient's liver function gradually returned to normal. This again proves that the definition of a "suitable graft" evolves with time and experience.
移植物的合适大小是肝移植成功的关键因素。小体积肝移植物很可能因缺血、保存、再灌注和排斥反应而遭受严重损伤。通常，小体积移植物在活体供肝肝移植中比在尸体供肝肝移植中更受关注。在此，我们描述了一例将一名2岁尸体供者的肝脏成功移植给一名61岁患有乙型肝炎相关肝衰竭男性受者的案例。文献中未发现供受者年龄和大小差异如此之大的尸体供肝肝移植成功报告。尽管差异异常大，但通过努力缩短缺血时间、改进手术技术以及“年轻”移植物强大的再生能力，老年患者的肝功能逐渐恢复正常。这再次证明“合适移植物”的定义会随着时间和经验而演变。
