肝肾一期联合移植临床分析  

Simultaneous Hepatorenal Transplantation.

作　　者：胡志林[1] 郭军[1] 柳樱竹[1] 

机构地区：[1]大连市友谊医院肾移植中心,116001

出　　处：《医学研究通讯》2004年第5期55-56,共2页Bulletin of Medical Research

摘　　要：目的探讨肝肾联合移植的手术技术、临床治疗经验和疗效。方法患者因乙型肝炎后肝硬化、肝功能不全,合并肝炎相关性肾病、尿毒症而施行一期肝肾联合移植。供体器官采用HTK液原位灌洗,快速联合切取。肝移植采用原位肝移植技术,肾移植采用常规方法。术前1小时予赛尼哌(Zenapax)行免疫诱导治疗。术后免疫抑制治疗采用普乐可复(FK506)、骁悉(MMC)、激素联合应用。术后40天开始服用抗乙型肝炎病毒药物贺普丁。结果患者术后无手术并发症发生,无排斥反应发生,移植肝肾功能良好,目前术后50天。结论肝肾联合移植是治疗肝肾功能衰竭的有效手段,完善的手术技术,严密的围手术期监测、并发症的正确处理是治疗成功的关键。Zenapax的免疫诱导以FK506为主的三联用药免疫抑制效果良好。Objective To investigate the surgical techniques,clinical experiences and therapentic effects of simultaneous hepateorenal transplantation.Methods Simultaneous hepateorenal transplantation was performed on one patient with liver cirrhosis of heparitis B,malfunction of liver,and hepatitis correlated nephrosis,uremia.Infusion in situ of the donors organs was carried out by UW solution and multiple organs were harvested.Liver and kindey transplantation was carried out by using orthotopic and ordinary methods respectively.Immunity induction therapy was performed with Zenapax one hour before preoperation,Immunosuppressive drugs consisted of FK506,MMC and corticosteroid.Laminvudine was used on day 40 postope.ration.Results Hie complications included acute and clironic refection has not.been taken placed since the transpla-tion day.Both transplant organs had rapidly normal functions postoperation,without primary nonfunction of liver graft happened.The patients has been survived for 50 days.Conclusion Combined hgepatorenal transplant is one of the utility treatment methods for liver and kindey function failure.Skilled operation teclmiques,comprehensive monitoring perioperatively and correct management are all major factors for success.The induction treatment of Zenapax and baseline imiminosuppression consisted of FK506 are effective and safe.

关 键 词：肝肾一期联合移植 临床分析 免疫诱导治疗 普乐可复 肝肾功能衰竭 

分 类 号：R657.3[医药卫生—外科学]