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肝脏移植中成功复用移植物:智利首例报告病例

Successful Reuse of a Liver Graft in Transplantation: First Reported Case in Chile.

作者信息

Galaz Valeria, Sotomayor Camila, Orellana Matías, Rebolledo Rolando, Benítez Julio, Buckel Erwin

机构信息

Department of Liver Transplant, Hepatobiliary, and Pancreatic Surgery, Hospital Dr. Sótero del Río, Santiago, CHL.

Department of Hepatobiliary and Pancreatic Surgery, Pontificia Universidad Católica de Chile, Santiago, CHL.

出版信息

Cureus. 2025 Feb 17;17(2):e79136. doi: 10.7759/cureus.79136. eCollection 2025 Feb.

Abstract

Organ donation in Chile remains low, creating a significant shortage of organs for transplantation and leading to long waiting times. A considerable proportion of patients on the liver transplant waiting list do not receive a transplant, often due to clinical deterioration or death. Several strategies exist to expand the organ pool for liver transplantation. The most commonly used approaches include living-donor liver transplantation, splitting a deceased donor liver into two grafts, and utilizing marginal donor grafts. Less frequently employed methods include donation after circulatory death (DCD), domino transplantation, and the reuse of previously transplanted livers. It is also crucial to optimize their utilization by carefully matching them with lower-risk recipients. There are some case reports and small series of cases regarding the successful reuse of liver grafts in the early and late post-transplant periods. We report the first case of the reuse of a deceased donor liver graft in Chile. A 51-year-old woman with fulminant liver failure initially received the graft, which was later donated following her brain death caused by an intracerebral hemorrhage. After undergoing two additional hours of ex situ hypothermic oxygenated perfusion (HOPE), the graft was successfully transplanted into a 55-year-old man with autoimmune hepatitis. The recipient recovered without complications.

摘要

智利的器官捐赠率仍然很低,导致移植器官严重短缺,等待时间漫长。相当一部分在肝移植等待名单上的患者无法接受移植,这通常是由于病情恶化或死亡。目前有几种策略可用于扩大肝移植的器官库。最常用的方法包括活体肝移植、将已故供体的肝脏分成两个移植物以及利用边缘供体移植物。较少使用的方法包括心脏死亡后捐赠(DCD)、多米诺移植以及重新使用先前移植的肝脏。通过仔细将它们与低风险受者匹配来优化其利用也很关键。有一些关于肝移植在移植后早期和晚期成功重复使用的病例报告和小系列病例。我们报告了智利首例已故供体肝脏移植物重复使用的病例。一名51岁暴发性肝衰竭女性最初接受了该移植物,后来在因脑出血导致脑死亡后捐赠。在进行了另外两小时的体外低温氧合灌注(HOPE)后,该移植物成功移植到一名患有自身免疫性肝炎的55岁男性体内。受者康复且无并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5043/11920923/3783ebfc06dd/cureus-0017-00000079136-i01.jpg

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