[1]陈焕伟,甄作均,苏树英,等.同种异体原位肝脏移植13例次临床经验[J].南方医科大学学报,2004,(04):445-447.
 CHEN Huan-wei,ZHEN Zuo-jun,SU Shu-ying,et al.Clinical experience with 13 cases of orthotopic liver transplantation[J].Journal of Southern Medical University,2004,(04):445-447.
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同种异体原位肝脏移植13例次临床经验()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2004年04期
页码:
445-447
栏目:
出版日期:
2004-04-01

文章信息/Info

Title:
Clinical experience with 13 cases of orthotopic liver transplantation
作者:
陈焕伟 甄作均 苏树英 许卓明 费凛 计勇
佛山市第一人民医院肝胆外科, 广东, 佛山, 528000
Author(s):
CHEN Huan-wei ZHEN Zuo-jun SU Shu-ying XU Zhuo-ming FEI Lin JI Yong
Department of Hepatobiliary Surgery, First People’s Hospital of Foshan, Foshan 528000, China
关键词:
肝移植肝硬化肝肿瘤移植同种
Keywords:
liver transplantationliver cirrhosisliver neoplasmstransplantation homologous
分类号:
R657.3
摘要:
目的 总结原位肝脏移植经验。方法 对12例患者实施13例次原位肝脏移植(包括1例再次肝移植),其中5例终末期肝硬化、4例原发性肝癌、1例肝癌术后肝功能衰竭、1例肝豆状核变性、1例慢性肾功能衰竭合并肝炎后肝硬化。手术方式:经典原位肝移植10例,改良背驮式肝移植2例,再次肝移植1例。结果 全组成功9例,最长存活超过2年;围手术期死亡4例,直接死亡原因脑出血1例、急性呼吸窘迫综合征1例、急性肾功能衰竭1例、肝动脉血栓1例。结论 肝脏移植是治疗各种终末期肝病的有效手段,但应严格掌握适应证,减少术后并发症的发生是提高肝移植成功率及长期存活率的关键。
Abstract:
Objective To review our experience with orthotopic liver transplantation. Methods Thirteen liver transplantation were performed in 12 patients (including one liver retransplantation), of whom 5 patients received the transplantation for end stage liver cirrhosis, 4 for primary liver carcinoma, 1 for liver failure after hepatectomy for liver cancer, 1 for Wilson’s disease, and 1 for chronic renal failure and liver cirrhosis. Retransplantation was done in 1 patient for chronic graft rejection. Of the 13 operations, 10 underwent the classical procedures of orthotopic liver transplantation, while 2 adopted modified piggyback technique, with 1 of the patients receiving retransplantation. Results Nine patients survived the transplantation with the longest survival over 2 years. Four patients died in the perioperative period, due to intracerebral bleeding, adult respiratory distress syndrome, acute renal failure and hepatic artery thrombus, respectively. Conclusions Liver transplantation is an effective treatment for various end-stage liver diseases. Strict patient selection, appropriate timing of the operation and proper perioperative care are all essential for the success of liver transplantation.

参考文献/References:

[1] Klintmalm GB. Liver transplantation for hepatocellular carcinoma: a registry report of the impact of tumor characteristics on outcome[J].Ann Surg, 1998, 228(4): 479-90.
[2] Penn I. Hepatic transplantation for primary and metastatic cancers of the liver[J]. Surgery, 1991, 110(4): 726-35.
[3] Wall WJ. Trends in liver transplantation: hepatocellular cancer and alcoholic liver disease[J]. Transplant Proc, 1998, 30(5): 1822-5.
[4] 黄洁夫.肝移植治疗原发性肝癌的现状及前景[J].肝胆外科杂志(J Hepatobil Surg), 1999, 7(3): 1-3.
[5] Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinoma in patients with cirrhosis[J]. N Engl J Med, 1996, 334(11): 693-9.
[6] 陈规划,陆敏强,何晓顺,等.改良背驮式肝移植69例报告[J].中国实用外科杂志(Chin J Pract Surg),2002,22(7):405-7.
[7] Markmann JF, Gornbein J, Markowitz, et al. A simple model to estimate survival after retransplantation of the liver[J]. Transplantation,1999, 67(3): 422-30.
[8] Ozaki CF, Katz SM, Monsour HP, et al. Surgical complication of liver transplantation[J]. Surg Clin North Am, 1994, 74(5): 1155-67.
[9] Mazariegos GV, Molmenti EP, Kramer DJ. Early complication after orthotopic liver transplantation[J]. Surg Clin North Am, 1999, 79(1): 109-29.

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备注/Memo

备注/Memo:
收稿日期:2003-10-25。
基金项目:广东省卫生厅医学科研基金(A2000729)
作者简介:陈焕伟(1967-),男,副主任医师,主要从事肝胆外科及肝移植的临床研究
更新日期/Last Update: 1900-01-01