猪异位辅助性部分肝移植术后移植肝功能监测

目的：对猪异位辅助性部分肝移植时移植肝功能的一系列临床观察与检查,探索植入肝功能监测方法及意义。方法：猪异位辅助性部分肝移植13次,观察供肝切取、植入肝血流复通进肉眼形态,监测血流动力学,生化变化,胆汁质量,行同位素及病理等检查以了解移植物功能。结果：手术当天死亡3例,存活3－180d,存活超过3月4例,若供肝灌注不均,植入肝复通血流颜色花斑状肿胀,提示供移植的肝功能不良,胆汁质和量的突然改变是并发症出现先兆,同位素扫描了解移植物灌流及胆道通畅情况,而系列活检对植入肝功能动态追踪及临床处理意义重大。结论：供肝质量,植入肝血流复通后移植物形态,胆汁分泌质量,同位素扫描,系列肝组织活检是监测辅助性肝移植术后肝功能状态的有效手段。

Liver Function monitoring After Auxiliary Partial Liver Transplantation in Swine

Objective:An experimental study was carried out to investigate the effcctive measure on monitoring graft function in auxiliary partial liver transplantation(APLT) in swine.Methods:The APLT was performed on 13 swine.The appearance of graft was observed while donor hepatoctomy,after revascularization.Hemodynamics,biochemistry or outflow of bile were monitored,Scintigraphy and pathological examination were carried out.Results:3 swine died within 24hours.The time of survival was from 3 days to 180days,4 swine were survival more than 3months.It is suggested that the graft function was low that the donor did not perfuse well,the graft was all the colours of rainbow and was swellen after revascularization, The biliary quality and output changed suddenly showed the complication may be appeared.Scintigraphy showed the condition of graft perfusion and biliary tract.Pathological finding in series would be of use for observing graft function and treatment. Conclusions:The donor viability, the appearance of graft after revascularization, biliary quality and output,scintigraphy and pathological finding in series were effective measure for monitoring graft function.