儿童劈离式肝移植38例临床效果分析  

A dinical report of split liver transplantation in pediatric recipients

作　　者：董冲[1] 高伟[2] 马楠[2] 张威[2] 孙超[2] 孟醒初[2] 王凯[2] 张伟晔[2] 沈中阳[2] 

机构地区：[1]天津医科大学一中心临床学院,300192 [2]天津市第一中心医院移植外科

出　　处：《中华器官移植杂志》2017年第8期469-473,共5页Chinese Journal of Organ Transplantation

基　　金：天津市科技计划项目（12ZCZDSY02600）

摘　　要：目的总结38例儿童劈离式肝移植的临床经验。方法回顾性分析2007年2月至2015年12月间38例儿童劈离式肝移植的临床资料，按照劈离式肝移植方式的不同分为两组，体外劈离式肝移植组（对照组）22例，在体原位劈离式肝移植组（研究组）16例。观察术后两组受者的存活率、移植肝功能恢复情况、再次移植率以及血管和胆道并发症的发生率，并对死亡受者的死亡原因进行分析。结果38例受者术后随访时间中位数为30．65个月（0．1～96．6个月），受者术后1年和3年累积存活率分别为81．6％和76．3％，移植肝术后1年和3年累积存活率分别为78．9％和63．8％。再次移植率13．16％（5／38），血管并发症发生率为31．58％（12／38）；胆道并发症发生率为31．58％（12／38）。38例受者中有9例死亡，其中与外科并发症相关的死亡人数为5例；对照组死亡4例（18．18％），研究组死亡1例（6．25％）。结论与体外劈离相比，供肝原位劈离能够改善婴幼儿肝移植受者术后长期存活率，并减少术后并发症的发生率。Objective To summarize the clinical experience in pediatric split liver transplantation （SLT） recipients. Methods A retrospective analysis was conducted on 38 cases of pediatric recipients using split donors during February 2007 to December 2015. The ex situ splitting technique was used for 22 grafts and in situ splitting technique was used for the rest 16 grafts. The survival rate of patients, recovery of liver function, re, transplantation rate, incidence of vascular complications and biliary complications were Observed, and the causes of death were analyzed. Results The median follow-up time of all the patients was 30. 65 months （0. 1-96. 6 months）. The 1- and 3- year cumulative survival rate was 81.6% and 76. 3% respectively. The re-transplantation rate was 13. 16%, the incidence of vessel complications was 31.58%, and biliary complication rate was 31.58%. There were 9 deaths, including 5 deaths which were related to surgical complications. Condmion SLT can expand the resource of liver donors for pediatric recipients. Comparing to ex situ split liver grafts, in situ split liver grafts can reduce morbidity and mortality of children after liver transplantation.

关 键 词：供肝 劈离 儿童 肝移植 

分 类 号：R726.5[医药卫生—儿科]