辅助性肝脏移植的免疫状态与血流动力学研究

目的 :探讨辅助性肝脏移植免疫学与血流动力学特点 ,从成功的辅助性肝脏移植中寻找解决移植物萎缩问题的对策。方法 :分析 3例辅助性肝脏移植患者的免疫学指标、病理学资料、血流动力学参数。结果 :辅助性肝脏移植患者免疫抑制剂浓度相对较低 ,排斥反应次数少 ,强度低。存活良好的辅助性肝移植患者移植肝无明显萎缩 ,移植肝门静脉流速和肝动脉流速略高 ,自身肝门静脉流速升高 ,肝动脉流速降低。结论 :辅助性肝脏移植术后处于免疫低反应状态。辅助性肝脏移植的移植物不萎缩的重要因素是保证充分的门静脉血供和肝动脉血供 ,血流重建的关键是吻合口径的控制和吻合部位的选择 ,不排除低浓度免疫抑制剂对移植肝脏副作用较小的可能

AUXILIARY LIVER TRANSPLANTATION:IMMUNOLOGY AND HEMODYNAMICS

Objective:To explore the immune status and hemodynamics of auxiliary liver transplantation and to find the way to control auxiliary graft atrophy. Methods:We analysed the immunology marker, pathologic data and hemodynamics parameter of these auxiliary liver transplantation patients.Results:Immunosuppressive agent concentration was lower, rejection was less and intensity was milder in these patients. The auxiliary graft of successful case was not atrophy. The graft portal vein flow rate and hepatic artery flow rate become faster than normal as well as the patient's original liver portal vein flow rate faster and hepatic artery flow rate slower. Conclusions:Patients are under low immune response status after auxiliary liver transplantation. The most important factor to preventing graft atrophy is to guarantee the blood supply of portal vein and hepatic artery and the key is to control calibre and locus of stoma properly. Possibly the less damage to graft of low concentration immunosuppressive agent plays role too.