心脏死亡供体肝移植12例初步经验

目的总结心脏死亡供体（DCD）肝移植的具体流程和临床经验。方法回顾性分析2008年10月至2012年12月中山市人民医院12例DCD临床资料、供体维护、器官获取、受体围手术期及预后等。结果12例供体均为脑、心双死亡供体，按标准成功完成了肝脏捐献及获取流程。其中3例使用体外膜肺氧合技术（ECMO）维持至器官获取。供肝热缺血时间0-30（16．5±7．0）min。12例受体均顺利植入供肝，无围手术期死亡。术后胆道并发症2例，肿瘤复发1例，死亡2例。结论DCD供体肝移植能获得较满意的效果。通过快速获取器官、合理利用ECMO，能提高器官捐献成功率、减少供肝热缺血时间及冷缺血时间。

Liver transplantation from donation after cardiac death

Objective To summarize the organ procurement process and clinical experiences in liver transplantation from donation after cardiac death. Methods The clinical data of 12 recipients undergoing liver transplantation from donation after cardiac death and pretreatment, procurement of 12 donors from Oct 2008 to Dec 2012 in Zhongshan City People＇s Hospital were retrospectively analyzed. Results The twelve donors were in the status of brain death awaiting cardiac death and had donated livers successfully. Of them, 3 donors were treated with extraeoporeal membrane oxygenation （ECMO）. The warm ischemia time of donation was 0-30 （16.5 ± 7.0） min. Liver transplantation was successfully performed on all recipients. There was no mortality during operation. 2 recipients suffered from biliary complication, 1 from tumor recurrence, and 2 recipients were dead during follow-up. Conclusions DCD might obtain satisfactory transplant outcomes and acceptable postoperative complications. Rapid procurement and ECMO can improve utilization rate and decrease warm and cold ischemia time of the liver.