单节段肝移植在体重小于 6 公斤婴儿肝移植中的应用：印度的初步经验。
Monosegment Liver Allografts for Liver Transplantation in Infants Weighing Less Than 6 kg: An Initial Indian Experience.
机构信息
Department of Multi-organ Transplant and HPB Surgery, Jupiter Hospital, Pune, India.
Department of Multi-organ Transplant and HPB Surgery, Jupiter Hospital, Pune, India.
出版信息
Transplant Proc. 2021 Jun;53(5):1670-1673. doi: 10.1016/j.transproceed.2021.01.005. Epub 2021 Feb 8.
BACKGROUND
Living donor liver transplantation in small infants is a significant challenge. Liver allografts from adults may be large in size. This is accompanied by problems of graft perfusion, dysfunction, and the inability to achieve primary closure of the abdomen. Monosegment grafts are a way to address these issues.
METHODS
Two recipients in our cohort weighed less then 6 kg. The prospective left lateral segments from their donors were large for size. Therefore, monosegment 2 liver grafts were harvested. Data regarding the preoperative, intraoperative, and postoperative events in the donor and the recipient were recorded.
RESULTS
We were able to achieve significant reduction in the sizes of the grafts harvested. The donors underwent surgery and hospital stay uneventfully. The recipients had normal graft perfusion and no graft dysfunction, and we could achieve primary abdominal closure. One recipient had self-limiting bile leak postoperatively.
CONCLUSIONS
Monosegment 2 liver allografts are safe and effective for use in living donor liver transplantation in small infants weighing less than 6 kg.
背景
在小婴儿中进行活体肝移植是一项重大挑战。成人供体的肝移植物可能体积较大。这伴随着移植物灌注、功能障碍以及无法实现腹部一期缝合的问题。单节段移植物是解决这些问题的一种方法。
方法
我们的队列中有两名体重小于 6 公斤的受者。他们供体的预期左外侧段体积过大。因此，我们采集了单节段 2 型肝移植物。记录了供体和受者术前、术中及术后的相关数据。
结果
我们成功地显著减小了所采集的移植物的体积。供者手术和住院过程均顺利。受者的移植物灌注正常，无移植物功能障碍，我们能够实现腹部一期缝合。一名受者术后出现自限性胆漏。
结论
对于体重小于 6 公斤的小婴儿活体肝移植，单节段 2 型肝移植物是安全有效的。
Zotero 插件