临床活体肝部分移植10例的适应证及手术时机

目的：探讨肝部分移植的适应证及手术时机．方法：以９例先天性胆道闭锁症、１例暴发性肝炎患者为对象：全组病例均为儿童，年龄３月龄～１２岁，其中男３例，女７例，均处于不同程度的肝功能不全状态．结果：全部病例均在全麻下接受了源自患儿父亲或母亲的部分肝移植术，手术历时１０～１５ｈ，出血量１０００ｍｌ左右，无肝期９０～２１０ｍｉｎ，术后恢复良好，移植肝脏全部成活．结论：现阶段临床活体肝部分移植的适应证多为先天性胆道闭锁症，移植对象多为儿童，手术时机应根据患者的病史及肝功能状况确定，目前尚无统一明确的标准．但一旦确定了肝移植的方针后，则应尽早手术．

Indications and timing of operation for 10 patients with clinical living related liver transplantation

Objective: To explore the indication and timing of operation for the clinical living related liver transplantation. Methods: Ten cases of clinical living related liver transplantation were presented, among which, 9 cases were congenital biliary atresia, one case was fulminant hepatitis. 3 cases were males and 7 females, with ages from 3 months to 12 years old. All the patients were in the conditions of hepatic insufficiency. Results: During 10 to 15 hours' operation, the patients accepted the partial liver from their parents with the non liver periods of 90 to 210 minutes, and the amount of bleeding was 1000 ml or so. The postoperative recoveries were satisfactory and the survival rate of transplanting liver was 100%. Conclusions: The results show that the indication of clinical living related liver transplantation on most cases is congenital biliary atresia in childhood. The timing of operation is various according to different individuals. Once the determination is made, the operation should be performed as soon as possible.