肝移植肝肾联合快速切取体会  

Experience of liver-kidney combined resection in liver transplantation

作　　者：邰沁文[1] 张金辉[1] 赵晋明[1] 曹峻[1] 白磊[1] 周成明[1] 温浩[1] 

机构地区：[1]新疆医科大学第一附属医院肝脏腹腔镜外科,新疆乌鲁木齐830054

出　　处：《新疆医学》2011年第1期5-8,共4页Xinjiang Medical Journal

摘　　要：目的:探讨提高和完善供肝切取修整与保存技术,提高器官利用率,减少肝移植术后近、远期并发症的发生。方法:2000年1月～2010年5月我院实施肝肾联合快速切取手术32例,快速切取技术采用原位腹主动脉、门静脉系统UW或HTK液灌注,整块切取肝脏、双侧肾脏。结果:供肝热缺血时间为3～6min,平均4min,冷缺血时间3～17h,平均8h,肝动脉解剖变异4例,术中肠系膜上静脉插管26例,门静脉插管4例,肠系膜下静脉插管2例。供肝均进行了肝移植手术,无肝脏弃用。1例行肝肾联合移植,1例行劈离式肝移植。结论:脑死亡供者肝肾联合快速切取技术能够可最大限度地缩短热缺血时间,有效避免变异血管损伤,为移植手术的成功提供了可靠的保证。Objective To explore the repair and preservation technology of liver resection ,improve organ utilization and reduce short--term and long--term complication after liver transplantation. Methods during January2000 to May2010,32 cases were performed by liver--kidney combined resection, rapid resection technique using abdominal aorta and portal vein perfusion with UW or HTK,liver and both kidneys were resectioned entirely. Results Liver warm is chemia time was 3 -6min,on averaae 4min, cold ischemia time was 3 - 17h, average time was 8h, there were 4 cases of hepatic art cases, portal vein catheterization in 4 cases and 2 cry in variation, superior mesenteric vien catheterization in 26 inferior mesenteric vein. AII donor liver transplantation were carried out, no liver abandoned. There were 1 case of liver - kidney transplantation and 1 case of split liver transplantation. Conclusion Liver---kidney combined resection of brain - dead donor can quickly minimize warm ischemia time, avoid vascular injury, provide reliable guarantee for liver transplantation.

关 键 词：肝移植 肝肾联合切取 器官保存 

分 类 号：R617[医药卫生—外科学]