132例同种异体肝移植获取的个人经验。
Personal experience with the procurement of 132 liver allografts.
作者信息
Yanaga K, Tzakis A G, Starzl T E
机构信息
Department of Surgery, University Health Science Center of Pittsburgh, University of Pittsburgh, PA 15213.
出版信息
Transpl Int. 1989 Oct;2(3):137-42. doi: 10.1007/BF02414600.
A single donor surgeon's experience procuring the livers from 132 donors is described. Thirty-seven grafts (28.9%) had hepatic arterial anomalies, 19 (14.4%) of which required arterial reconstruction prior to transplantation. Of the 121 grafts evaluated for early function, 103 grafts (85.2%) functioned well, whereas 14 grafts (11.6%) functioned poorly and 4 grafts (3.3%) failed to function at all. The variables associated with less than optimal function of the graft consisted of donor age (P less than 0.05), duration of donor's stay in the intensive care unit (P less than 0.005), abnormal graft appearance (P less than 0.05), and such recipient problems as vascular thromboses during or immediately following transplantation (P less than 0.005). A new preservation fluid, University of Wisconsin solution, allowed safe and longer cold storage of the liver allograft than did Euro-Collins' solution (P less than 0.0001). A parameter of liver allograft viability, which is simple and predictive of allograft function prior to the actual transplant procedure, is urgently needed.
本文描述了一位供体外科医生从132名供体获取肝脏的经验。37个移植物（28.9%）存在肝动脉异常，其中19个（14.4%）在移植前需要进行动脉重建。在评估早期功能的121个移植物中，103个移植物（85.2%）功能良好，而14个移植物（11.6%）功能较差，4个移植物（3.3%）完全无功能。与移植物功能未达最佳相关的变量包括供体年龄（P<0.05）、供体在重症监护病房的停留时间（P<0.005）、移植物外观异常（P<0.05）以及诸如移植期间或移植后立即发生的血管血栓形成等受体问题（P<0.005）。一种新的保存液，即威斯康星大学溶液，与欧洲柯林斯溶液相比，能使肝脏同种异体移植物更安全且更长时间地冷藏保存（P<0.0001）。迫切需要一个简单且能在实际移植手术前预测同种异体移植物功能的肝脏同种异体移植物活力参数。
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