尸体供者小肠、肝和肾脏器联合切取及保存技术  

Techniques for procurement and preservation of intestine,liver and kidneys grafts from the same cadaveric donor

作　　者：李元新[1] 李幼生[1] 李民[1] 

机构地区：[1]南京军区南京总医院普通外科研究所,210002

出　　处：《中华移植杂志（电子版）》2010年第4期12-16,共5页Chinese Journal of Transplantation(Electronic Edition)

基　　金：国家科技支撑计划项目(2008BAI60B06)

摘　　要：目的建立尸体供者全腹腔脏器切取和保存技术,同时为不同的小肠移植、肝移植和肾移植受者提供供器官。方法共进行8次同一尸体供者的全腹腔脏器切取手术。供体切取经腹主动脉与肠系膜下静脉插管,高渗枸橼酸-腺苷肾保存液及UniversityofWisconsin液原位灌注,肝、小肠、胰腺、脾、肾整块切取。供器官经后台修整后,分别成为肝、小肠和肾移植物进行相应的受者移植手术。结果 8次供者腹腔脏器切取和后台修整手术共获取8具小肠移植物、8具肝移植物和16具肾移植物。利用所修整出的供器官成功地完成5次单独小肠移植、8次肝移植和16次肾移植,术后移植物功能良好。结论所建立的尸体供者全腹腔脏器切取和保存技术,可同时为不同的小肠移植、肝移植和肾移植受者提供供器官;借鉴美国匹兹堡大学的供者器官后台分离技术,还可同时为胰腺移植受者提供供器官。Objective To establish the techniques for procurement and preservation of full abdominalgrafts from the same non-heart-beating donor,and to transplant the intestine,liver and kidney allografts retrieved from the same donor to different recipients.Methods Eight procurements of full abdominalgrafts from the same non-heart beating donor were performed.The donor organs were harvested in situ by infusion with hypertonic citrate-adenine solution and University of Wisconsin solution and the grafts including the intestine,liver,pancreas,and kidneys were harvested en bloc.On the back table,the intestine,liver and 2 kidney grafts were separated from the organ cluster,and then were simultaneously transplanted to different recipients.Results Eight procurements of the donor grafts including the back-table procedures were accomplished and all allografts were intact.Five isolated small intestine,8 liver,and 16 kidney transplants were performed with these grafts.None of these allografts sustained serious ischemic injury.Conclusions Our refined technique for procurement and preservation of full abdominal grafts from the same cadaveric donor can harvest intestinal,liver,and kidney allografts and simultaneously transplant to different recipients.Furthermore,with the ex vivo separating technique of allografts on back table of the University of Pittsburgh,pancreatic graft may also be simultaneously harvested.

关 键 词：器官切取 器官保存 小肠移植 肝移植 肾移植 胰腺移植 

分 类 号：R617[医药卫生—外科学]