胚胎异位辅助肝移植1例报告

本文报告世界首例应用胚胎异位辅助肝移植治疗晚期肝硬变。供者系同血型水囊引产9月死胎。用改良Starzl法切取胚肝;将供肝植于受者肝下右脊柱旁间隙,作胎肝上腔静脉-受者肝下肾静脉以上下腔静脉端侧吻合,脐静脉-受者肠系膜上静脉端侧吻合,腹腔动脉-受者胃网膜右动脉端端吻合;胆总管结扎,胆囊-空肠Roux-y吻合。手术经过顺利,通血后移植肝血循良好。术后第3日死于食道胃底静脉曲张破裂,失血性休克,伴多脏器功能衰竭。作者对胎肝移植的可行性,手术指征和时机进行了讨论

Auxiliary Fetel Livar Transplantation(One Case Report)

Auxiliary fetal liver transplantation was performed for one case with late stage of cirrhosis of the liver on Decmber 22,1988.There was no clinical practice of this operat- ion in the world before that time.The donor was an artificially delivered died fetus, aged nire months.The liver was harvested by modified Starzl's method.The graft was placed in the right paravertebral gutter just below the host liver.The fetal superior hepatic vena cava was anastomosed to recipient inferior vena cava above renal vein by end to side type.Then umbilical vein of the graft to recipient superior mesenteric vein (end-to-side)and fetal celiac artery to right gastroepiploic artery(end-to-side)anasto- mosis were parfermed.Common bile duct was ligated.Gallbladder-jejunum Roux-y anast- omosiswas done.The operation was done smoothly.After raconstruction of the blood ves- sels the graft appeared good blood circulation.On the third day after operation the pati- ent died of hypovolemic shock with MOF caused by rupture of the esophageai and gastric varices.The practicality,indications and opportunity of the operation were discused.