临床肝脏移植20年回顾  

A twenty-year review of clinical liver transplantation

作　　者：沈中阳[1] 谷川[1] 郑虹[1] 潘澄[1] 邓永林[1] 杜洪印[2] 朱志军[3] 刘懿禾[1] 孙丽莹[3] 刘振文 蒋文涛[1] 张雅敏[1] 高伟[1] 蔡金贞[1] 张建军[1] 沈文[5] 唐缨[6] 李延钧[1] 张玮晔[1] 宋红丽[1] 王政禄[7] 张弋[8] 于立新[1] 滕大洪[1] 郭庆军[1] Shen Zhongyang;Gu Chuan;Zheng Hong;Pan Cheng;Deng Yonglin;Du Hongyin;Zhu Zhijun;Liu Yihe;Sun Liying;Liu Zhenwen;Jiang Wentao;Zhang Yamin;Gao Wei;Cai Jinzhen;Zhang Jianjun;Shen Wen;Tang Ying;Li Yanjun;Zhang Weiye;Song Hongli;Wang Zhenglu;Zhang Yi;Yu Lixin;Teng Dahong;Guo Qingjun(Organ Transplantation Center, Tianjin First Center Hospital, Tianjin Clinical Medical Research Center for Organ Transplantation, Key Laboratory of National Health Commission for Critical Care and Emergency Medicine, Key Laboratory of Chinese Academy of Medical Sciences for Organ Transplantation, Tianjin Key Laboratory for Organ Transplantation, Tianjin 300192, China;Department of Anesthesiology, Tianjin First Center Hospital, Tianjin 300192, China;Organ Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;Department of Hepatobiliary Surgery, the Fifth Medical Center of PLA General Hospital, Organ Transplantation Center, Beijing 100039, China;Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China;Department of Ultrasonography, Tianjin First Center Hospital, Tianjin 300192, China;Department of Pathology, Tianjin First Center Hospital, Tianjin 300192, China;Department of Pharmacy, Tianjin First Center Hospital, Tianjin 300192, China)

机构地区：[1]天津市第一中心医院器官移植中心/天津市器官移植临床医学研究中心/国家卫生健康委员会危重病急救医学重点实验室/中国医学科学院移植医学重点实验室/天津市器官移植重点实验室,300192 [2]天津市第一中心医院麻醉科,300192 [3]首都医科大学附属北京友谊医院肝脏移植中心,100050 [4]解放军总医院第五医学中心肝胆外科/肝移植中心,北京100039 [5]天津市第一中心医院放射科,300192 [6]天津市第一中心医院超声科,300192 [7]天津市第一中心医院病理科,300192 [8]天津市第一中心医院药学部,300192

出　　处：《中华危重病急救医学》2019年第3期269-280,共12页Chinese Critical Care Medicine

基　　金：国家自然科学基金(81670574,81670600,81870444);天津市自然科学基金(17JCYBJC27500,17JCQNJC12800,18JCYBJC44400).

摘　　要：目的回顾天津市第一中心医院成人及儿童肝脏移植发展历程,旨在增进学术交流,改进科技创新,携手促进学科的进步与成熟。方法分析天津市第一中心医院肝脏移植发展概况,以及1998年9月至2018年9月施行成人及儿童肝脏移植患者的资料,总结器官移植中心20年间的肝脏移植重要事件与科技创新成果。结果天津市第一中心医院于1980年4月即开始尝试临床肝脏移植;1994年完成国内首例长期存活的成人肝脏移植(术后存活11年);于1998年9月正式组建肝脏移植专业团队;至今20多年的临床探索与发展历程,映射了中国肝脏移植快速发展期的年代变化特点与科技创新的嬗变过程。该中心于1999年1月开展再次肝脏移植;2000年8月开展减体积供肝小儿肝脏移植;2001年5月组织制定肝脏移植术后乙型肝炎(乙肝)复发防治方案;2002年7月开展肝肾联合移植;2004年4月开展劈离式肝脏移植(SLT);2005年8月完成首例多米诺肝脏移植(DLT);2006年10月开展小儿活体肝脏移植(LDLT);2007年8月开展成人LDLT;2007年9月完成亚洲首例同一供者活体肝肾联合移植;2009年1月开展国际首例多米诺+活体供肝双供肝肝脏移植;2011年3月开展腹腔镜辅助含肝中静脉活体右半肝供肝肝脏移植;2014年5月开展全腹腔镜下左外侧叶供肝获取;2016年4月开展同期肝胰肾多器官联合移植;2017年2月开展多米诺供肝辅助肝脏移植,同年12月开展体外膜肺氧合(ECMO)支持的合并重度肺动脉高压的肝脏移植;2018年4月开展联合脾部分切除术的肝脏移植,同年5月开展交叉多米诺供肝(辅助肝脏移植的高致敏肾移植+儿童肝脏移植)。20年间,该团队完成及协助北京、上海、广州、深圳等省市兄弟单位开展肝脏移植累积超过1万例,其中该院单中心共完成各类型肝脏移植7?043例(成人6?005例,儿童1?038例),1998年9月至2003年3月,成人肝脏移植术后1、3、5年累积生存Objective To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation. Methods The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized. Results The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic ve

关 键 词：肝脏移植 单中心分析 团队创新 迭代式进步 可持续发展 

分 类 号：R657.3[医药卫生—外科学]