多米诺肝移植临床效果分析(附2例报告)  

Clinical efficacy of domino liver transplantation:An analysis of two cases

作　　者：张慧[1] 王建红[1] 王淑贤[1] 冯帅 刘金泉 徐祥美 戴德淑 孙爽[1] 许传屾[1] ZHANG Hui;WANG Jianhong;WANG Shuxian;FENG Shuai;LIU Jinquan;XU Xiangmei;DAI Deshu;SUN Shuang;XU Chuanshen(Organ Transplantation Center,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院器官移植中心,山东青岛266003

出　　处：《精准医学杂志》2024年第1期71-73,77,共4页Journal of Precision Medicine

摘　　要：目的探讨多米诺肝移植(DLT)的临床疗效,为肝移植手术扩大供肝来源提供借鉴。方法收集我院2021年完成的2例DLT患者的临床资料,并进行文献复习。结果供者1为健康人,受者1(DLT供者)为鸟氨酸氨甲酰基转移酶缺乏症(OTCD)患者,受者2(DLT受者)为Cirgler-Najiar综合征患者;供者2为国际标准化脑死亡捐献者,受者3(DLT供者)为家族性高胆固醇血症(FH)患者,受者4(DLT受者)为肝脏恶性肿瘤患者。所有患者的肝功能均于术后1周左右基本恢复正常,住院治疗2~4周后均顺利出院。其中受者2(DLT受者)术后第4天发现门静脉左支血栓形成,行急诊溶栓加药物抗凝治疗,门静脉血流得到有效改善,未造成严重后果,胆红素于术后1周恢复正常。受者4(DLT受者)术后出现高脂血症,联合应用阿托伐他汀+依折麦布调脂治疗,随访至今未出现其他并发症。结论采用DLT可有效扩大肝移植手术供肝来源。Objective To investigate the clinical efficacy of domino liver transplantation(DLT)and to provide a refe-rence for expanding the sources of donor livers.Methods The clinical data of two cases who underwent DLT at our hospital in 2021 were collected,and a literature review was performed.Results Donor 1 was a healthy subject,recipient 1(DLT donor)was a patient with ornithine transcarbamylase deficiency,and recipient 2(DLT recipient)was a patient with Cirgler-Najiar syndrome.Donor 2 was a brain-dead donor as per the internationally standardized definitions,recipient 3(DLT donor)was a patient with familial hypercholesterolemia,and recipient 4(DLT recipient)was a patient with malignant liver tumor.After transplantation,all patients experienced recovery of their liver function in 1 week,and were discharged from the hospital after 2 to 4 weeks of hospitalization.Recipient 2 developed thrombosis in the left portal vein on day 4 after operation;after emergent thrombolysis and anticoagulant therapy,the blood flow of the portal vein was effectively improved,and no serious outcomes were identified;the bilirubin level of the patient returned to normal at 1 week after operation.Recipient 4 developed hyperlipidemia after operation and was treated with atorvastatin and ezetimibe for lipid regulation;the patient was followed up till now with no additional complications found.Conclusion DLT can effectively expand the sources of donor livers.

关 键 词：肝移植 移植受体 活体供者 治疗结果 病例报告 

分 类 号：R617[医药卫生—外科学]