原位肝脏移植术后肝动脉并发症的诊治

目的：探讨肝脏移植术后肝动脉并发症的诊断和处理。方法：回顾性总结107例肝脏移植患者的临床资料,分析肝脏移植手术中可能影响术后肝动脉并发症发生的危险因素,以及肝动脉并发症的预防、诊断和处理措施。结果：肝脏移植术后肝动脉并发症的发生与外科手术方式相关。供肝动脉的质量和供体-受体动脉的重建方式是两个重要因素。术后共发生动脉相关的并发症7例,发生率6．54％;其中死亡6例,死亡率85．7％;主要是肝动脉血栓形成和肝动脉狭窄。结论：供肝动脉的质量和动脉的重建方式是影响术后肝动脉并发症发生的主要因素。早期诊断、早期治疗是处理肝动脉相关并发症,挽救植入器官和患者生命的关键。

The diagnosis and treatment of hepatic artery complications in 107 cases of orthotopic liver transplantation

Objective To investigate the diagnosis and managements of hepatic artery complications in orthotopic liver transplantation. Methods The clinical data of 107 consecutive orthotopic liver transplantation patients was reviewed retrospectively to assess the risk factors and the diagnosis and treatment of the vascular complications. Results The incidence of the artery related complications in orthotopic liver transplantation was associated with the quality of the donor organ artery and the reconstruction way of donor recipient artery intimately. The main hepatic artery related complications were hepatic artery thrombosis and stenosis. The incidence of the vascular complications was 6 54%, and the mortality rate was 85 7%. Conclusions The main influence factors of vascular complications were the quality of the donor organ artery and the reconstruction way of donor recipient artery. The key steps of organ salvaging and the patients' life saving were early diagnosis and treatment of those complications.