Yeung C K, Ho J K, Lau W Y, Lee K H, Li A K
Department of Surgery, Chinese University of Hong Kong, Shatin.
Postgrad Med J. 1996 Jul;72(849):427-8. doi: 10.1136/pgmj.72.849.427.
In the Orient, millions are known to have Clonorchis sinensis (biliary trematodiasis) infestation. When these infested livers become available as donor organs, there are potentially serious implications that the transplant team would need to consider. We report the use of two such infested livers, one from a cadaveric donor and the other from a live related donor, for orthotopic liver transplantation. The parasite was encountered not only during organ procurement, but also caused early postoperative blockage of the hepatico-jejunostomy splintage tube and cessation of bile flow in the second recipient. Upon follow-up for four and two years, respectively, no other ill effect has been observed in either patient. Repeated examination of stool for ova of C sinensis in both patients during follow-up visits had been negative, indicating that all the parasites probably had been killed by the cold perfusion. In view of the severe shortage of liver grafts and the lack of serious morbidity associated with the use of these infested livers, we have adopted the policy to include these livers for future transplantation. Special considerations and precautions are, however, required during the perioperative period and on long-term follow-up.
在东方，数以百万计的人被认为感染华支睾吸虫（肝吸虫病）。当这些受感染的肝脏作为供体器官可用时，移植团队需要考虑一些潜在的严重问题。我们报告了使用两个这样受感染的肝脏进行原位肝移植的情况，一个来自尸体供体，另一个来自活体亲属供体。不仅在器官获取过程中发现了寄生虫，而且在第二位受者中，寄生虫还导致术后早期肝空肠吻合支撑管堵塞和胆汁流动停止。分别对两位患者进行了四年和两年的随访，未观察到其他不良影响。在随访期间，对两位患者的粪便反复进行华支睾吸虫卵检查均为阴性，表明所有寄生虫可能已被冷灌注杀死。鉴于肝移植供体严重短缺，且使用这些受感染肝脏未出现严重并发症，我们已采取政策将这些肝脏纳入未来移植。然而，在围手术期和长期随访期间需要特别考虑和采取预防措施。
