儿童逝世后器官捐献腹部器官联合切取76例临床研究  

An improved surgical technique for combined abdominal organ harvesting in organ donation after citizen death of children： a study of 76 cases

作　　者：蓝柳根[1] 秦科[1] 董建辉[1] 曹嵩[1] 黄莹[1] 廖吉祥[1] 高照[1] 刘旭阳[1] 李壮江[1] 周洁惠[1] 孙煦勇[1] 

机构地区：[1]中国人民解放军303医院移植医学研究院广西移植医学重点实验室广西移植医学工程技术研究中心广州军区器官移植中心,广西南宁市530021

出　　处：《中华肝胆外科杂志》2016年第8期530-533,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：广西科学研究与技术开发计划项目（桂科攻14124003-8）;广西壮族自治区卫生与计生委员会课题（Z2015293,Z2016520）

摘　　要：目的探讨儿童逝世后腹部器官联合切取术的手术方法。方法2007年8月至2015年12月，76例儿童供者经过死亡判定、签署器官捐献相关文件、器官功能维护后，按照器官捐献流程实施了腹部器官联合切取术。采用自制腹主动脉插管灌注肾保存液，胰腺下沿肠系膜上静脉外科干处置入输液导管行门静脉灌注。结果低温灌注平均时间为1．5min，平均热缺血时间为3min。76例共获取供肝65个及供肾130个。供肝经国家人体器官分配与共享计算机系统分流至其他儿童肝移植中心行42例肝移植，我院完成121例。肾移植。发生移植肝原发无功能3例，24例移植。肾功能延迟恢复（DGF）经血液透析后恢复正常。结论经过器官功能维护，儿童逝世后腹部器官联合切取，采用自制腹主动脉插管行动脉灌注＋肠系膜上静脉外科干处置入输液导管灌注可保证供肝、供肾质量，不但可有效缩短热缺血时间、快速降温，而且灌注充分。采用该法所获器官进行肝肾移植临床效果良好，并发症少，值得临床推广应用。Objective To study an improved surgical technique for combined abdominal organ har- vesting from cadaveric donors in DCD of children. Methods The technique of combined abdominal organ harvesting has been refined using liver perfusion via the trunk of the superior mesentery vein （ SMV）, and this technique was used 76 times in harvesting. Results The mean time to establish hypothermia flushing was 1.5 minutes, and the mean hot ischemia time was 3 minutes. Organ harvesting resulted in 65 livers and 130 kidneys. Kidney transplantation was performed in our hospital on 121 patients, and liver transplantation was performed in other centers with the organs being distributed by CORTS. Primary liver dysfunction was found in 3 patients, and DGF which recovered well with hemodialysis was found in 24 patients. No injuries of hepatic and renal arteries occurred. Conclusions This improved technique shortened hot ischemic time, and improved quality of the harvested organs. The cadaveric organs functioned well after transplantation. This technique can be used more widely in clinical practice.

关 键 词：肝移植 肾移植 多器官联合切取 

分 类 号：R726.5[医药卫生—儿科]