背驮式肝移植技术及有关问题探讨(附32例报道)

目的　探讨肝移植治疗各种终末期肝病的外科新技术。方法　 1995年 9月至 1999年9月 ,对 30例患者施行了 32次背驮式肝移植术。其中包括 1例减体积肝移植 ,1例肝肾联合移植 ,1例辅助肝肾联合移植 ,1例原旁位心房架桥肝移植 ,2例原位肝后下腔静脉心房架桥肝移植。结果　32次肝移植术均获成功 ,未发生手术技术相关并发症。有 2例良性终末期肝病已分别存活 2年 10个月～ 4年 ,1998年以来施行背驮式肝移植术的良性终末期肝病患者 1年存活率达 70 % (14/2 0 ) ,肝肾联合移植及辅助肝肾联合移植的 2例已存活近 1年。结论　背驮式肝移植作为八十年代末兴起的新技术具有无需转流 ,血流动力学稳定 ,内环境干扰小等优点。

Investigation on PBLT technique and concerned questions with a report of 32 cases

Objective To explore a new surgical technique of liver transplantation (LT) which is used to treat the end stage liver disease.Methods 32 case of LT were subjected to piggy back transplantation from Sep. 1995 to Sep.1999. Of the 30 cases, one received combined liver kidney transplantation, one paraorthotopic bridge to atrium LT and two orthotopic inferior vena cavabridge to atrium LT.Results All patients underwent successful LT and had no technique related complications. Of the 32 cases, 2 cases of benign end stage liver diseases had survived for 34 months and 48 months respectively. From 1998, the one year survival rate in the patients with benign end stage liver disease receiving LT reached 70%.Conclusion The piggy back LT is characterized by no veno venous bybass,stability of hemodynamics and homeostasis.