国内首例肝移植受者移植供肝再利用  

Successful reuse of liver allograft from liver transplant recipient:the first case report in China

作　　者：薛洪源 沈丛欢 陶一峰 李瑞东 李建华 周秀玲 张全保 王正昕 Xue Hongyuan;Shen Conghuan;Tao Yifeng;Li Ruidong;Li Jianhua;Zhou Xiuling;Zhang Quanbao;Wang Zhengxin(Liver Transplantation Center,Department of General Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Ultrasound,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院普外科肝脏移植中心,上海200040 [2]复旦大学附属华山医院超声医学科,上海200040

出　　处：《中华器官移植杂志》2025年第1期69-73,共5页Chinese Journal of Organ Transplantation

摘　　要：移植供肝短缺是限制肝移植开展的最主要因素,并成为移植等待者脱失及死亡最主要的原因。移植供肝的再利用是少见但具有重要意义的非常规供肝资源,是扩大供肝池的重要策略,该策略在国外已有诸多文献报道,并取得了较为理想的手术结局及长期随访结果。复旦大学附属华山医院普外科肝脏移植中心进行了国内首例移植供肝再利用尝试,该案例中首位受者因急性肝衰竭、肝性脑病行原位肝移植术,术后第7天病情恶化,达到脑死亡标准;经评估、维护后该供肝再次移植于1例肝移植术后6 d、因急性肝动脉栓塞致移植肝功能急剧恶化需紧急二次肝移植的受者,术后该受者肝脏功能恢复顺利,于术后第28天出院。这一结果提示,移植供肝的再利用对于扩大潜在供肝来源、挽救危急状态移植等待者等具有重要价值。The shortage of donor organs is the primary factor limiting the availability of liver transplantation(LT)and is a leading cause of death among patients on the waiting list.The reuse of liver allografts,while rare,represents a significant and unconventional donor resource,offering a promising strategy to expand the donor pool.This approach has been documented in international literature,demonstrating favorable surgical outcomes and long-term follow-up results.Here,we report the first case of liver allograft reuse in the Liver Transplantation Center,Department of General Surgery,Huashan Hospital,Fudan University.In this case,the first recipient underwent orthotopic LT for acute liver failure and hepatic encephalopathy.However,their condition deteriorated on the seventh postoperative day,culminating in brain death.Following evaluation and maintenance,the liver allograft was successfully re-transplanted into a second recipient,who had undergone LT six days earlier but experienced acute hepatic artery embolism leading to rapid liver function deterioration.The second recipient's liver function recovered smoothly after surgery,and they were discharged on the 28th postoperative day.This case highlights the significant value of liver allograft reuse in expanding the donor pool and providing life-saving options for critically ill patients requiring urgent LT.

关 键 词：肝移植 脑死亡 再利用 肝动脉栓塞 

分 类 号：R657.3[医药卫生—外科学]