早期移植肝无功能再次肝移植病例的经验  

Experience of liver retransplantation for early graft nonfunction

作　　者：王冠武 李亭[1] 颉斌[1] Wang Guanwu;Li Ting;Xie Bin(Department of General Organ Transplantation,2nd Xiangya Hospital,Central South University,Changsha 410011,Hunan,China)

机构地区：[1]中南大学湘雅二医院普外器官移植科,湖南长沙410011

出　　处：《实用器官移植电子杂志》2019年第2期103-105,共3页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的总结早期移植肝无功能再次肝移植的临床治疗经验。方法回顾性分析6例早期移植肝无功能再次肝移植患者的临床资料,与首次肝移植的相关指标对比分析。结果 6例再次肝移植均顺利完成手术,患者均无术中死亡,术后短期病死率为50%(3/6)。再次肝移植患者术前终末期肝病模型(model for end-stage liver disease,MELD)评分高于首次肝移植(分:34.67±5.64比20.67±8.29,P <0.05),手术时间低于首次肝移植(min:388.33±64.47比474.83±76.41,P <0.05),术中输血量高于首次肝移植(ml:4 631.25±1 393.19比3 739.58±1 930.82,P <0.05),无肝期时间与首次肝移植无显著差异。再次肝移植术后感染率为66.7%(4/6)。结论再次肝移植是早期移植肝无功能的有效治疗手段,但风险仍高。Objective To summarize therapeutic experience of liver retransplantation for early graft nonfunction.Methods Six cases of liver retransplantation for early graft nonfunction were analyzed retrospectively and surgical related indicators were compared with first liver transplantation.Results Operations were successfully performed in all 6 cases and 3 out of 6 patients died during early postoperative period.The model for end-stage liver disease(MELD)scores before second operation were higher than their first operation(scores:34.67±5.64 vs.20.67±8.29,P<0.05).The operation time of second operation was longer than that of first operation(min:388.33±64.47 vs.474.83±76.41,P<0.05).The volume of blood transfusion in second operation was more than that in first operation(ml:4 631.25±1 393.19 vs.3 739.58±1 930.82,P<0.05).There was no significant difference in anhepatic phase between second and first operation.The rate of post-operative infection after retransplantation was 66.7%(4/6).Conclusion Liver retransplantation is the effective treatment for early graft nonfunction but with high risk.

关 键 词：移植肝无功能 再次肝移植 术后感染 血浆透析滤过 

分 类 号：R657.3[医药卫生—外科学]