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First two cases of living related liver transplantation with complicated anatomy of blood vessels in Beijing

机译:北京地区前两例生活相关性肝移植并发血管解剖

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摘要

AIM: Living related liver transplantation (LRLT) has been developed in response to the paediatric organ donor shortage. Though it has been succeeded in many centers worldwide, the safety of the donor is still a major concern, especially in donors with anatomy variation. We succeeded in performing the first two cases of living related liver transplantation with complicated anatomy of blood vessels as a way to overcome cadaveric organ shortage in Beijing.METHODS: Two patients, with congenital liver fibrosis and congenital biliary atresia were performed with living donor liver transplantation in our hospital and then followed up from November 12 to December 13, 2001. The two living donors, mother and father, were healthy aged 34 and 35 years. One right lobe (segment V, VI, VII, VIII) and one left lateral lobe (segment II and III) were used. The grafts weighed 394 g and 300 g. The ratio of graft weight to the standard liver volume (SLV) of donors was 68% and 27%. The graft weight to recipient body weight ratio was 3.2% and 4.4%. The graft weight to recipient estimated standard liver mass (ESLM) ratio was 63% and 85%. The two donors had complicated blood vessel variation.RESULTS: Two patients undergone living donor liver transplantation had good results. Abnormal liver function with high bilirubin level appeared in a few days after operation, but liver function returned to normal one month after operation with bilirubin level almost decreased to near normal. No bleeding, thrombosis, infection and bile leakage occurred. One had an acute rejection and recovered. The two donors recovered in two weeks. One had slight fever because of a little collection in abdomen and recovered after paracentesis and drainage.CONCLUSION: Living donor liver transplantation has been proved to be a good way that offers a unique opportunity of getting a timely liver graft as a response to shortage of pediatric donors, though it could be a technically difficult operation if there is anatomical variation.
机译:目的:针对儿童器官捐赠者的短缺,开发了与生活有关的肝移植(LRLT)。尽管它已经在全球许多中心获得成功,但供体的安全性仍然是一个主要问题,尤其是在解剖结构不同的供体中。我们成功地完成了前两例活体相关肝移植并伴有复杂的血管解剖结构,从而克服了尸体器官短缺的问题。方法:两名患者,先天性肝纤维化和先天性胆道闭锁,并进行了活体供体肝移植。在我们医院进行随访,并于2001年11月12日至12月13日进行了随访。两个活着的捐献者,母亲和父亲,年龄分别为34岁和35岁。使用一个右叶(V,VI,VII,VIII段)和一个左侧叶(II和III段)。移植物重394 g和300 g。供体的移植物重量与标准肝体积(SLV)的比率为68%和27%。移植物重量与受体体重的比率为3.2%和4.4%。移植物重量与接受者的估计标准肝质量(ESLM)比率分别为63%和85%。结果:两名活体肝移植患者均取得了良好的治疗效果。术后几天内出现高胆红素水平的肝功能异常,但术后一个月肝功能恢复正常,胆红素水平几乎降至接近正常水平。没有出血,血栓形成,感染和胆汁渗漏发生。一个人遭到了急性排斥并康复了。两名捐助者在两周内康复。结论:活体供体肝移植被证明是一种很好的方法,可以为及时获得肝移植提供机会,以应对小儿科的短缺,这是一个很好的方法,因为腹部收集很少,可以恢复原状。供体,尽管如果存在解剖上的差异,这在技术上可能会很困难。

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