Katoh H, Ohkohchi N, Satomi S, Shimaoka S, Ohi R
Second Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Tohoku J Exp Med. 1997 Jan;181(1):139-44. doi: 10.1620/tjem.181.139.
Eleven children, 4 males and 7 females, with biliary atresia receiving living related liver graft were studied. The mean age was 1.8 years and the mean body weight was 10.3 kg. The donors were 4 fathers and 7 mothers. The graft was the lateral segment or left lobe. ABO blood group matching was compatible in 9 and incompatible in 2. All patients except one were crossmatch negative. Immunosuppression at induction was triple therapy (cyclosporine, azathioprine and steroid) or FK506 plus steroid. Acute rejection episodes were treated with pulse steroids. When the signs of rejection persisted despite steroid pulse therapy, 15-deoxyspergualin (DSG) was added. The survival rate of the patients was 73%. Three patients died of portal vein thrombosis, hepatic artery thrombosis and sepsis respectively. Other major complications included hyperbilirubinemia, bile duct stenosis, bile leakage and portal vein anastomosis narrowing. Complications of the donor were sepsis in one, and liver dysfunction in two. Although there are some complications related to graft size mismatch and operative procedure, living related partial liver transplantation is an effective therapy in countries where donor source is restricted.
对11例接受亲属活体肝移植的胆道闭锁患儿进行了研究，其中男性4例，女性7例。平均年龄为1.8岁，平均体重为10.3千克。供体为4名父亲和7名母亲。移植的是肝外侧段或左叶。ABO血型匹配9例相容，2例不相容。除1例患者外，所有患者交叉配血均为阴性。诱导期免疫抑制采用三联疗法（环孢素、硫唑嘌呤和类固醇）或FK506加类固醇。急性排斥反应采用类固醇冲击治疗。当尽管进行了类固醇冲击治疗但排斥反应迹象仍持续时，加用15-去氧精胍菌素（DSG）。患者的生存率为73%。3例患者分别死于门静脉血栓形成、肝动脉血栓形成和败血症。其他主要并发症包括高胆红素血症、胆管狭窄、胆漏和门静脉吻合口狭窄。供体的并发症有1例发生败血症，2例出现肝功能障碍。尽管存在一些与移植物大小不匹配和手术操作相关的并发症，但在供体来源受限的国家，亲属活体部分肝移植是一种有效的治疗方法。
