Reyes J, Fishbein T, Bueno J, Mazariegos G, Abu-Elmagd K
Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh Intestinal Care Center, Pennsylvania 15213, USA.
Transplantation. 1998 Aug 27;66(4):489-92. doi: 10.1097/00007890-199808270-00013.
A composite graft consisting of a reduced left lateral hepatic segment in continuity with the small intestine was procured from an adult cadaveric donor using a modified in situ split technique. The primary recipient was a 3-year-old boy with hepatointestinal failure. The right side of the liver was transplanted into a 63-year-old man with a central hepatoma and hepatitis C cirrhosis. This was accomplished with center-to-center sharing of the liver portion of the allograft. The in situ split technique was feasible, with good initial allograft function. However, both grafts failed subsequently because of peri-operative recipient-related complications. The adult patient died of an infected pseudoaneurysm of the arterial graft, and the pediatric patient required repeat transplantation as a result of the late diagnosis of a native pancreatic fistula with cholestatic damage to the reduced liver allograft. The child is currently alive 8 months after repeat transplantation.
采用改良的原位劈离技术，从一名成年尸体供体获取了一段由与小肠相连的左外侧肝段组成的复合移植物。首位受者是一名患有肝肠衰竭的3岁男孩。肝脏右侧被移植到一名患有中央型肝癌和丙型肝炎肝硬化的63岁男性体内。这是通过同种异体移植物肝脏部分的中心对中心共享来完成的。原位劈离技术是可行的，同种异体移植物初始功能良好。然而，由于围手术期受者相关并发症，两个移植物随后均失败。成年患者死于动脉移植物感染性假性动脉瘤，而小儿患者因先天性胰瘘诊断延迟且对缩小的肝脏同种异体移植物造成胆汁淤积性损伤而需要再次移植。该患儿在再次移植8个月后目前存活。
