活体肝移植：国王学院医院的经验。
Split liver transplantation: King's College Hospital experience.
作者信息
Rela M, Vougas V, Muiesan P, Vilca-Melendez H, Smyrniotis V, Gibbs P, Karani J, Williams R, Heaton N
机构信息
Liver Transplantation Surgical Service, Department of Radiology, King's College Hospital, London, UK.
出版信息
Ann Surg. 1998 Feb;227(2):282-8. doi: 10.1097/00000658-199802000-00019.
BACKGROUND
The purpose of split liver transplantation is to increase the source of pediatric grafts without compromising the adult donor pool. Early results have been discouraging because of technical complications and selection of poor risk patients.
METHODS
The results of a single center experience of 41 split liver transplantations were analyzed. Patient and graft survival and complications related to the technique were analyzed.
RESULTS
Patient and graft survival for the whole group was 90% and 88% respectively at a median follow up of 12 months (range 6-70 months). Patient and graft survival for the right lobe graft was 95% and the left lateral segment 86% and 82% respectively. Four patients died, of which two of the patients were first two splits following technical complications. Two others died, one from cerebral lymphoma and the other of multiorgan failure secondary to sepsis. One patient has been retransplanted for chronic biliary sepsis.
CONCLUSION
Split liver transplantation has now become an acceptable treatment option for both adult and pediatric recipients with end stage liver disease. Right lobe recipients are not disadvantaged by the procedure. Good results can be achieved with better patient selection and by the use of good quality organs.
背景
劈离式肝移植的目的是在不影响成人供肝库的情况下增加小儿移植物的来源。由于技术并发症以及对高危患者的选择，早期结果并不理想。
方法
分析了一个中心41例劈离式肝移植的经验。分析了患者和移植物的存活情况以及与该技术相关的并发症。
结果
在中位随访12个月（范围6 - 70个月）时，整个组的患者和移植物存活率分别为90%和88%。右叶移植物的患者和移植物存活率分别为95%，左外侧叶分别为86%和82%。4例患者死亡，其中2例是在技术并发症后最初的两例劈离手术患者。另外2例死亡，1例死于脑淋巴瘤，另1例死于败血症继发的多器官功能衰竭。1例患者因慢性胆汁性败血症接受了再次移植。
结论
劈离式肝移植现已成为晚期肝病成人和小儿受者均可接受的治疗选择。右叶受者不会因该手术而处于劣势。通过更好的患者选择和使用高质量的器官可以取得良好的效果。
Zotero 插件